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Impact of tonsillotomy versus tonsillectomy on health-related quality of life and healthcare costs in children with sleep-disordered breathing

Part of: JLO Editors' Choice Papers 2022

Published online by Cambridge University Press:  25 November 2021

A J Sakki ,
R P Roine ,
L K Mäkinen ,
H Sintonen  and
J Nokso-Koivisto
A J Sakki*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Finland
R P Roine
Affiliation:
Helsinki and Uusimaa Hospital Group, Group Administration, Finland and University of Eastern Finland, Kuopio, Finland
L K Mäkinen
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Finland
H Sintonen
Affiliation:
Department of Public Health, University of Helsinki, Finland
J Nokso-Koivisto
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Finland
*
Author for correspondence: Dr A J Sakki, Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital, P.O. Box 263, Finland E-mail: anniina.sakki@fimnet.fi
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Abstract

Objective

This study aimed to explore health-related quality of life and use of healthcare services and ensuing costs before and after tonsillotomy in children with sleep-disordered breathing and to compare the results to an earlier cohort of children who had undergone tonsillectomy.

Method

Children undergoing tonsillotomy answered the 17-dimensional, standardised health-related quality of life instrument questionnaire and a questionnaire on use of healthcare services and sick leave before and after surgery. Costs of specialist care were obtained pre- and post-operatively. The data were compared with similar data collected previously from children with tonsillectomy.

Results

Tonsillotomy improved mean total health-related quality of life score significantly at 6 and 12 months. Healthcare costs and number of sick-leave days diminished significantly from 3 months pre-operatively to 12 months after surgery. Tonsillotomy had similar positive effects compared with tonsillectomy regarding health-related quality of life and healthcare costs.

Conclusion

Tonsillotomy improves health-related quality of life in children with sleep-disordered breathing and reduces healthcare service needs and sick leave similarly to tonsillectomy.

Keywords

Tonsil SurgeryHealth Related CostsQuality Of LifeChildSleep-Disordered Breathing

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 5 , May 2022 , pp. 454 - 460
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr A J Sakki takes responsibility for the integrity of the content of the paper

References

Borgstrom, A, Nerfeldt, P, Friberg, D, Sunnergren, O, Stalfors, J. Trends and changes in paediatric tonsil surgery in Sweden 1987-2013: a population-based cohort study. BMJ Open 2017;7:e013346CrossRefGoogle ScholarPubMed
Sakki, A, Makinen, LK, Roine, RP, Nokso-Koivisto, J. Changing trends in pediatric tonsil surgery. Int J Pediatr Otorhinolaryngol 2018;118:84–9CrossRefGoogle ScholarPubMed
Baldassari, CM, Mitchell, RB, Schubert, C, Rudnick, EF. Pediatric obstructive sleep apnea and quality of life: a meta-analysis. Otolaryngol Head Neck Surg 2008;138:265–73CrossRefGoogle ScholarPubMed
Koempel, JA, Solares, CA, Koltai, PJ. The evolution of tonsil surgery and rethinking the surgical approach to obstructive sleep-disordered breathing in children. J Laryngol Otol 2006;120:993–1000CrossRefGoogle ScholarPubMed
Eriksson, M, Nilsson, U, Bramhagen, AC, Idvall, E, Ericsson, E. Self-reported postoperative recovery in children after tonsillectomy compared to tonsillotomy. Int J Pediatr Otorhinolaryngol 2017;96:47–54CrossRefGoogle ScholarPubMed
Walton, J, Ebner, Y, Stewart, MG, April, MM. Systematic review of randomized controlled trials comparing intracapsular tonsillectomy with total tonsillectomy in a pediatric population. Arch Otolaryngol Head Neck Surg 2012;138:243–9CrossRefGoogle Scholar
Acevedo, JL, Shah, RK, Brietzke, SE. Systematic review of complications of tonsillotomy versus tonsillectomy. Otolaryngol Head Neck Surg 2012;146:871–9CrossRefGoogle ScholarPubMed
Aronen, ET, Liukkonen, K, Simola, P, Virkkula, P, Uschakoff, A, Korkman, M et al. Mood is associated with snoring in preschool-aged children. J Dev Behav Pediatr 2009;30:107–14CrossRefGoogle ScholarPubMed
Leiberman, A, Stiller-Timor, L, Tarasiuk, A, Tal, A. The effect of adenotonsillectomy on children suffering from obstructive sleep apnea syndrome (OSAS): the Negev perspective. Int J Pediatr Otorhinolaryngol 2006;70:1675–82CrossRefGoogle ScholarPubMed
Tarasiuk, A, Greenberg-Dotan, S, Simon-Tuval, T, Freidman, B, Goldbart, AD, Tal, A et al. Elevated morbidity and health care use in children with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 2007;175:55–61CrossRefGoogle ScholarPubMed
Gudnadottir, G, Tennvall, GR, Stalfors, J, Hellgren, J. Indirect costs related to caregivers' absence from work after paediatric tonsil surgery. Eur Arch Otorhinolaryngol 2017;274:2629–36CrossRefGoogle ScholarPubMed
Escarra, F, Vidaurreta, SM. Assessment of quality of life before and after an adenotonsillectomy among children with hypertrophic tonsils and/or adenoids. Arch Argent Pediatr 2015;113:21–7Google ScholarPubMed
Nokso-Koivisto, J, Blomgren, K, Roine, RP, Sintonen, H, Pitkaranta, A. Impact of tonsillectomy on health-related quality of life and healthcare costs in children and adolescents. Int J Pediatr Otorhinolaryngol 2014;78:1508–12CrossRefGoogle ScholarPubMed
Ericsson, E, Graf, J, Lundeborg-Hammarstrom, I, Hultcrantz, E. Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up. J Otolaryngol Head Neck Surg 2014;43:26CrossRefGoogle Scholar
Ericsson, E, Ledin, T, Hultcrantz, E. Long-term improvement of quality of life as a result of tonsillotomy (with radiofrequency technique) and tonsillectomy in youths. Laryngoscope 2007;117:1272–9CrossRefGoogle ScholarPubMed
Ericsson, E, Lundeborg, I, Hultcrantz, E. Child behavior and quality of life before and after tonsillotomy versus tonsillectomy. Int J Pediatr Otorhinolaryngol 2009;73:1254–62CrossRefGoogle ScholarPubMed
Wireklint, S, Ericsson, E. Health-related quality of life after tonsillotomy versus tonsillectomy in young adults: 6 years postsurgery follow-up. Eur Arch Otorhinolaryngol 2012;269:1951–8CrossRefGoogle Scholar
Colen, TY, Seidman, C, Weedon, J, Goldstein, NA. Effect of intracapsular tonsillectomy on quality of life for children with obstructive sleep-disordered breathing. Arch Otolaryngol Head Neck Surg 2008;134:124–7CrossRefGoogle ScholarPubMed
Vicini, C, Eesa, M, Hendawy, E, Pari, M, D'Agostino, G, AlGhamdi, S, Meccariello, G. Powered intracapsular tonsillotomy vs. conventional extracapsular tonsillectomy for pediatric OSA: a retrospective study about efficacy, complications and quality of life. Int J Pediatr Otorhinolaryngol 2015;79:1106–10CrossRefGoogle Scholar
Apajasalo, M, Rautonen, J, Holmberg, C, Sinkkonen, J, Aalberg, V, Pihko, H et al. Quality of life in pre-adolescence: a 17-dimensional health-related measure (17D). Qual Life Res 1996;5:532–8CrossRefGoogle ScholarPubMed
Hujanen, T, Kapiainen, S, Tuominen, U, Pekurinen, M. Terveydenhuollon yksikkökustannukset Suomessa vuonna 2006 (The unit costs of health care in Finland 2006). Helsinki: Stakes, 2008Google Scholar
The Association of Finnish Municipalities. In: http://www.localfinland.fi [13 March 2020]Google Scholar
Hultcrantz, E, Ericsson, E. Pediatric tonsillotomy with the radiofrequency technique: less morbidity and pain. Laryngoscope 2004;114:871–7CrossRefGoogle ScholarPubMed
Hultcrantz, E, Linder, A, Markström, A. Long-term effects of intracapsular partial tonsillectomy (tonsillotomy) compared with full tonsillectomy. Int J Pediatr Otorhinolaryngol 2005;69:463–9CrossRefGoogle ScholarPubMed
de la Chaux, R, Klemens, C, Patscheider, M, Reichel, O, Dreher, A. Tonsillotomy in the treatment of obstructive sleep apnea syndrome in children: polysomnographic results. Int J Pediatr Otorhinolaryngol 2008;72:1411–7CrossRefGoogle ScholarPubMed
Koltai, PJ, Solares, CA, Koempel, JA, Hirose, K, Abelson, TI, Krakovitz, PR et al. Intracapsular tonsillar reduction (partial tonsillectomy): reviving a historical procedure for obstructive sleep disordered breathing in children. Otolaryngol Head Neck Surg 2003;129:532–8CrossRefGoogle ScholarPubMed
Parker, NP, Walner, DL. Trends in the indications for pediatric tonsillectomy or adenotonsillectomy. Int J Pediatr Otorhinolaryngol 201;75:282–5Google Scholar
Landau, YE, Bar-Yishay, O, Greenberg-Dotan, S, Goldbart, AD, Tarasiuk, A, Tal, A. Impaired behavioral and neurocognitive function in preschool children with obstructive sleep apnea. Pediatr Pulmonol 2012;47:180–8CrossRefGoogle ScholarPubMed
Stewart, MG, Glaze, DG, Friedman, EM, Smith, EO, Bautista, M. Quality of life and sleep study findings after adenotonsillectomy in children with obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 2005;131:308–14CrossRefGoogle ScholarPubMed
Gudnadottir, G, Ehnhage, A, Bende, M, Andersson, M, Cervin, A, Cardell, LO et al. Healthcare provider contact for children with symptoms of sleep-disordered breathing: a population survey. J Laryngol Otol 2016;130:296–301CrossRefGoogle ScholarPubMed
Ahlqvist-Rastad, J, Hultcrantz, E, Svanholm, H. Children with tonsillar obstruction: indications for and efficacy of tonsillectomy. Acta Paediatr Scand 1988;77:831–5CrossRefGoogle ScholarPubMed
Basha, S, Bialowas, C, Ende, K, Szeremeta, W. Effectiveness of adenotonsillectomy in the resolution of nocturnal enuresis secondary to obstructive sleep apnea. Laryngoscope 2005;115:1101–3CrossRefGoogle ScholarPubMed
Odhagen, E, Sunnergren, O, Hemlin, C, Hessen Soderman, AC, Ericsson, E, Stalfors, J. Risk of reoperation after tonsillotomy versus tonsillectomy: a population-based cohort study. Eur Arch Otorhinolaryngol 2016;273:3263–8CrossRefGoogle ScholarPubMed
Sintonen, H. The 15D instrument of health-related quality of life: properties and applications. Ann Med 2001;33:328–36CrossRefGoogle ScholarPubMed
Richardson, J, Iezzi, A, Khan, MA, Chen, G, Maxwell, A. Measuring the sensitivity and construct validity of 6 utility instruments in 7 disease areas. Med Decis Making 2016;36:147–59CrossRefGoogle ScholarPubMed