Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
A Comparison of Outcomes in Adult Patients After Intracapsular Laser Tonsillotomy and Cold Steel Tonsillectomy.
СтатьяСравнительное исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Skaaraas Gry H E S, Nordahl Stein H G, Jacobsen Yngve M, Wennberg Siri, Blindheimsvik Martin A B, Bugten Vegard
Аннотация
OBJECTIVE: This study compares selection criteria, 30-day complications, and 6-month outcomes between intracapsular tonsillotomy (TT) using carbon dioxide (CO2) laser and traditional cold steel tonsillectomy (TE).
STUDY DESIGN: A retrospective, observational study.
SETTING: Laser TT was conducted at 6 different Norwegian hospitals or private clinics and 41 Norwegian hospitals or private clinics performed traditional cold steel TE.
METHODS: We analyzed data from the Norwegian Tonsil Surgery Register (NTSR), including all adult patients (≥16 years) undergoing tonsil surgery from January 1, 2017, to June 30, 2023. No exclusion criteria were applied. The data are based on 3 questionnaires: one completed by surgeons on the day of surgery, and one completed by patients 30 days and 6 months after surgery.
RESULTS: Laser TT was associated with significantly lower postoperative bleeding and fewer pain-related healthcare contacts. However, cold steel TE had higher symptom resolution at 6 months (P < .001). Men had a higher risk of bleeding (P < .001), while women more often sought help for pain (P < .001). Patients with recurrent or chronic tonsillitis had greater risks for both bleeding and pain-related contacts. Women were more likely to report persistent symptoms at 6 months (P = .01).
CONCLUSION: Laser TT under local anesthesia is associated with fewer short-term complications but a higher rate of persistent symptoms compared to traditional cold steel tonsillectomy (TE). In this study, cold steel TE demonstrated significantly better long-term outcomes. Careful patient selection for laser TT is essential.
STUDY DESIGN: A retrospective, observational study.
SETTING: Laser TT was conducted at 6 different Norwegian hospitals or private clinics and 41 Norwegian hospitals or private clinics performed traditional cold steel TE.
METHODS: We analyzed data from the Norwegian Tonsil Surgery Register (NTSR), including all adult patients (≥16 years) undergoing tonsil surgery from January 1, 2017, to June 30, 2023. No exclusion criteria were applied. The data are based on 3 questionnaires: one completed by surgeons on the day of surgery, and one completed by patients 30 days and 6 months after surgery.
RESULTS: Laser TT was associated with significantly lower postoperative bleeding and fewer pain-related healthcare contacts. However, cold steel TE had higher symptom resolution at 6 months (P < .001). Men had a higher risk of bleeding (P < .001), while women more often sought help for pain (P < .001). Patients with recurrent or chronic tonsillitis had greater risks for both bleeding and pain-related contacts. Women were more likely to report persistent symptoms at 6 months (P = .01).
CONCLUSION: Laser TT under local anesthesia is associated with fewer short-term complications but a higher rate of persistent symptoms compared to traditional cold steel tonsillectomy (TE). In this study, cold steel TE demonstrated significantly better long-term outcomes. Careful patient selection for laser TT is essential.