The effectiveness of unilateral tonsillectomy in chronic adenotonsillar hypertrophy

Yıl 2005, Cilt: 15 Sayı: 1, 14 - 18, 10.03.2005

Ahmet Kutluhan Hüseyin Çaksen Veysel Yurttaş Muzaffer Kırış Köksal Yuca

Öz

Objectives: This study sought to determine whether unilateral tonsillectomy was effective in the treatment of chronic adenotonsillar hypertrophy.Patients and Methods: A total of 197 patients 96 giriş, 101 boys with chronic adenotonsillar hypertrophy were prospectively included. The patients were ran- domly assigned to eitherbilateral tonsillectomy n=113; mean age 10.1 years; range 4 to 18 years or unilater­ al tonsillectomy n=84; mean age 4.5 years; range 3 to 8 years performed with or without adenoidectomy. AH the patients were followed-up for at least a year.Results: The two groups did not differ significantly with respect to preoperative symptoms, the size of tonsils, and the presence of adenoid hypertrophy. At the end of the follow-up, no significant differences were found with respect to relief of snoring, mouth breathing, and upper airways obstruction between the two groups. A greater number of patients achieved complete improvement in snoring in the bilateral tonsillectomy group p<0.05 . With unilater­ al tonsillectomies, three patients required tonsillecto­ my to the other side, two had recurrent tonsillitis, and one had severe compensatory hypertrophy with persistent difficulty in inspiration and mouth breathing.Conclusion: Unilateral tonsillectomy seems to be as effective as bilateral tonsillectomy in the treatment of chronic adenotonsillar hypertrophy.

Anahtar Kelimeler

Adenoidectomy, adolescent, child, tonsillecto­ my, tonsillitis/complications/surgery

Kronik adenotonsiller hipertrofili hastalarda tek taraflı tonsillektominin etkinliği

Öz

Amaç: Çalışmada, kronik adenotonsiller hipertrofitedavisinde tek taraflı tonsillektominin etkili olup olmadığı araştırıldı.Hastalar ve Yöntem: Kronik adenotonsiller hipertrofili 197 hasta 96 kız, 101 erkek prospektif olarakçalışmaya alındı. Hastalar, iki taraflı veya tek taraflı tonsillektomi ve/veya adenoidektomi uygulanmak üzere rastgele seçimle ikigruba ayrıldı. Her iki ameliyatın klinik sonuçları ameliyattan en az bir yıl sonra değerlendirildi.Bulgular: Gruplar arasında, ameliyat öncesindesemptomlar, tonsil büyüklüğü ve adenoid hipertrofivarlığı yönünden anlamlı farklılık saptanmadı. İzlemsüresi sonunda, horlama, ağız solunumu ve üst solunum yolları tıkanıklığının düzelmesi bakımındaniki grup arasında anlamlı farklılık görülmedi. İkitaraflı tonsillektomi grubunda horlamada tamdüzelme görülen hasta sayısı anlamlı derecedefazlaydı p

Anahtar Kelimeler

Adenoidektomi, adölesan, çocuk, tonsillektomi, tonsillit/komplikasyon/cerrahi

Kaynakça

• Wiatrack BJ, Woolley AL. Pharyngitis and adenoton- sillar disease. In: Cummings CW, Fredrickson JM, Harker LA, Krause CJ, Richardson MA, Schuller DE, editors. Otolaryngology Head & Neck Surgery (Pediatric Otolaryngology), Vol 5. St. Louis: Mosby; 1998. p. 188-215.
• Francois M. What is the role of tonsillectomy in chil- dren? Arch Pediatr 2000;7:79-82. [Abstract]
• Christensen PH, Schonsted-Madsen U. Unilateral immediate tonsillectomy as the treatment of periton- sillar abscess: results, with special attention to pharyn- gitis. J Laryngol Otol 1983;97:1105-9.
• Lima JA, Autin JL. Immediate unilateral tonsillectomy for severe peritonsillar infections in children. Int J Pediatr Otorhinolaryngol 1983;6:187-93.
• Gray LP. Unilateral tonsillectomy-indications and results. J Laryngol Otol 1983;97:1111-9.
• Gal P, Baranova A. Adeno-tonsillectomy and unilater- al tonsillectomy. Cesk Otolaryngol 1988;37:43-6. [Abstract]
• Laubscher HH. Unilateral tonsillectomy. S Afr Med J 1989;76:515-6.
• Ikram M, Khan MA, Ahmed M, Siddiqui T, Mian MY. The histopathology of routine tonsillectomy speci- mens: results of a study and review of literature. Ear Nose Throat J 2000;79:880-2.
• Kutluhan A, Ugras S, Kiris M, Cankaya H, Kiroglu AF, Yurttas V. Differences in clinical and histopathologic features between chronic adenotonsillitis and chronic adenotonsillar hypertrophy. Kulak Burun Bogaz Ihtis Derg 2003;10:61-7. [Abstract]
• Brodsky L, Moore L, Stanievich JF. A comparison of tonsillar size and oropharyngeal dimensions in chil- dren with obstructive adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 1987;13:149-56.
• Kornblut A, Kornblut AD. Tonsillectomy and ade- noidectomy. In: Otolaryngology. Philadelphia: WB Saunders; 1991. p. 2149-65.
• Erişen L, Basut O, Coşkun H, Tezel İ, Hızalan İ, Onart S. Adenotonsillektomi olgularımız ve endikasyon- larının değerlendirilmesi. Kulak Burun Boğaz Klinikleri 1999;1:85-8.
• Rosenfeld RM, Green RP. Tonsillectomy and ade- noidectomy: changing trends. Ann Otol Rhinol Laryngol 1990;99(3 Pt 1):187-91.