Volume reduction of tonsil hyperplasia in childhood with a surgical ultrasound device

Background: We present the results of a prospective study concerning the use of a surgical-ultrasound device (use of ultrasound mechanical vibrations in the tonsil tissue with denaturising effect on collagen and proteins for tonsil ablation, coablation) for the therapy of non-infectious tonsillar hyperplasia resulting in upper airway obstruction in childhood. Method: 51 patients with a median age of 6.9 years (3.5-12 years) were treated with surgical ultrasound, under general anesthesia. The intervention did not include tissue excision, but the denaturation of hyperplastic tonsil tissue. Intra- and postoperative bleeding, pain (by visual analog scale), tonsil-to-tonsil diameter and swallowing difficulties were under consideration. Also an bacteriological examination of tonsils was performed. Results: The procedure was generally well tolerated. There was no intra- or postoperative bleeding. Swallowing difficulties were described as not very disturbing. Median follow up was 2.1 years. The postoperative ,,wound healing" lasted 7-9 days. A reduction of tonsil's size was visible since the first post treatment week with the final results occuring after 3-6 months. Interton-sillar distance was 9 mm preoperatively and 22.14 mm after co-ablation. A higher incidence of bacterial tonsillitis or development of quinsies were not reported. Conclusion: The treatment of tonsilar hyperplasia by means of surgical ultrasound is highly effective and causes relatively mild post surgical complaints without intra- or postoperative bleeding.