667:: When a laser is used to perform tonsillectomy, it can be under local anaesthetic with anaesthetic spray only, called tonsillotomy (or tonsil resurfacing or partial tonsillectomy), or it can be performed under general anaesthetic when it is called intra-capsular tonsillectomy, using an operating microscope for magnification. The carbon dioxide laser in scanning mode is an excellent vapouriser of tissue, and in conjunction with a computerised pattern generator and operating microscope with micromanipulator, it can result in near total removal of tonsil tissue whilst preserving the capsule of the tonsil. This leads to a significantly reduced bleeding and pain rate. The local anaesthetic technique takes around 10 minutes, the general around 20 minutes depending on the size of the tonsils - the bigger they are, the longer it takes. The general anaesthetic operation has a revision rate of 1:50, the local anaesthetic tonsillotomy 1:4.5. This is different from procedures where a laser is used to reduce or resurface the tonsils (e.g. laser cryptolysis). Providing the absence of certain contra-indications such as sensitive
614:: This surgical procedure is performed using plasma to remove the tonsils. Coblation technology combines radiofrequency energy and saline to create a plasma field. The plasma field is able to dissociate molecular bonds of target tissue while remaining relatively cool (40–70 °C), which results in minimal or no damage to surrounding healthy tissue. A Coblation tonsillectomy is carried out in an operating room setting, with the patient under general anesthesia. Tonsillectomies are generally performed for two main reasons: tonsillar hypertrophy (enlarged tonsils) and recurrent tonsillitis. It has been claimed that this technique results in less pain, faster healing, and less post operative care. However, review of 21 studies gives conflicting results about levels of pain, and its comparative safety has yet to be confirmed. This technique has been criticized for a higher than expected rate of bleeding presumably due to the low temperature which may be insufficient to seal the divided
252:
the subsequent one or two years, compared to those who do not. Specifically one review of five randomized controlled trials, found a decrease from 3.6 to 3.0 episodes in the year following surgery. In less severely affected children, surgery results in an increase, rather than a decrease of sore throats when the sore throat directly following surgery is included. Surgery results in a reduction in school absence in the following year, but the strength of evidence is low. Surgery does not result in an improvement in the quality of life. Benefits of surgery do not persist over time. Those with frequent throat infections often spontaneously improve over a year without surgery. Therefore, a certain number of people who undergo surgery will do so unnecessarily as they would not have had further episodes of tonsillitis had they not had surgery. Evidence in adults is unclear.
801:
indications (i.e. frequent enough sore throats to justify surgery). The majority of tonsillectomies were undertaken for indications which did not have an evidence-base: five to six sore throats in one year (12.4%), two to four sore throats in one year (44.6%), sleep disordered breathing (12.3%), or obstructive sleep apnea (3.9%). In the UK therefore, most children who undergo tonsillectomy probably do not benefit and most children who might benefit do not undergo tonsillectomy. The study concluded that 32,500 (close to 90%) out of the 37,000 children who have their tonsils removed annually "are unlikely to benefit" and that surgery therefore may do more harm than good to those children. Tonsillectomy rates are lower in the UK than in most other western
European countries.
264:
and the unknown risk of general anesthesia exposure in children four years of age. In considering the potential harms, the guideline panel agreed that there was not a clear preponderance of benefit over harm for tonsillectomy, even for children meeting the
Paradise criteria . Instead, the group felt there to be a balance that allows either tonsillectomy or watchful waiting as an appropriate management option for these children and does not imply that all qualifying children should have surgery. The role of tonsillectomy as an option in managing children with recurrent throat infection means that there is a substantial role for shared decision making with the child's caregiver and primary care clinician.
243:. However, it is unclear whether the removal of the adenoid has any additional positive or negative effects for the treatment of recurrent sore throat. In cases of chronic tonsillitis in adults, there is strong evidence of increased quality of life, reduction of symptoms, and economic benefit. A randomised controlled trial of tonsillectomy versus medical treatment (antibiotics and pain killers) in adults with frequent tonsillitis found that tonsillectomy was more effective and cost effective. It resulted in fewer days with sore throat.
1223:". There was also an increasing concern regarding the psychological and physical suffering of young children as a result of surgery. Furthermore, opponents of surgery argued that the tonsils should be retained whenever possible because of their role in the immune system and that the benefits of surgery were marginal. In the 1970s, tonsillectomy rates in the United Kingdom started to decline after several studies concluded that tonsillectomy was not as effective for sore throats and many other indications as previously thought.
1199:), became the standard instrument for tonsil removal for over 80 years. By 1897, it became more common to perform complete rather than partial removal of the tonsil after American physician Ballenger noted that partial removal failed to completely alleviate symptoms in a majority of cases. His results using a technique involving removal of the tonsil with a scalpel and forceps were much better than partial removal; tonsillectomy using the guillotine eventually fell out of favor in America.
1215:. From the 1940s to 1970s, further studies found an association between tonsillectomy and bulbar poliomyelitis with recommendations not to do the operation during outbreaks. Controversy surrounding tonsillectomy increased further in the United Kingdom in the 1960s because of the financial costs associated with the number of surgeries being performed and because of unexplainable variations in tonsillectomy rates between geographic regions and between
451:
712:. A dose of dexamethasone during surgery prevents vomiting in one out of every five children. A dose of dexamethasone may help children return to a normal diet more quickly and have less post-operative pain. Many people are prescribed antibiotics following a tonsillectomy, however, the benefits and potential harms have not been well studied. Antibiotics are not suggested to be used routinely following tonsillectomy.
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reimbursement system and say to himself, "You know what? I make a lot more money if I take this kid's tonsils out." Now, that may be the right thing to do. But I'd rather have that doctor making those decisions just based on whether you really need your kid's tonsils out or whether it might make more sense just to change – maybe they have allergies. Maybe they have something else that would make a difference.
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postoperative pain and early return to daily activities, fewer secondary infections of the tonsil bed and significantly lower rates of secondary hemorrhage. Unlike the electrosurgery procedure, Coblation
Tonsillectomy generates significantly lower temperatures on contacted tissue. Long-term studies seem to show that surgeons experienced with the technique have very few complications.
31:
459:
773:
considerably between neighbouring countries. For example, rates in
Croatia are three times those in Slovenia. Variations between countries may be explained by a lack of or differences between guidelines. However differences in guidelines cannot explain the seven-fold variation between local authority areas within England.
618:
but several papers offer conflicting (some positive, some negative) results. More recent studies of coblation tonsillectomy indicate reduced pain and ostalgia; less intraoperative or postoperative complications; lesser incidence of delayed hemorrhage, more significantly in pediatric populations, less
389:
It is estimated 1.3% of people will have a delayed discharge (of 4 to 24 hours) due to a complication, and up to 3.9% will require repeat admission to hospital. The main reasons for either keeping a person in hospital, or readmitting them after tonsillectomy are uncontrolled pain, vomiting, fever, or
263:
Caregivers and patients who meet the appropriate criteria for tonsillectomy as described here should be advised of only modest anticipated benefits of tonsillectomy, as weighed against the natural history of resolution with watchful waiting, as well as the risk of surgical morbidity and complications
1202:
In the beginning of the 20th century, tonsillectomy became more common in the United
Kingdom and the United States and by the 1930s was very common in both countries. For example, a study conducted in 1934 found that 61% of 1,000 New York schoolchildren had been tonsillectomized; doctors recommended
660:
to seal and divide the tissue. The absence of thermal spread means that the temperature of surrounding tissue is only 2–3 °C higher than normal body temperature. Clinical papers show patients with minimal post-operative pain (no requirement for narcotic pain-killers), zero edema (swelling) plus
603:
occurs within the tonsil causing it to decrease in size over a period of several weeks. The treatment can be performed several times. The advantages of this technique are minimal discomfort, ease of operations, and immediate return to work or school. Tonsillar tissue remains after the procedure but
251:
Surgery is not recommended for those with fewer than seven documented throat infections in the last year, fewer than five each year for the last two years, or fewer than three each year for three years. Severely affected children who undergo surgery on average have one fewer sore throat per year in
686:
surgery. It is made up of a cannula or tube, connected to a hand piece, which in turn is connected to a motor with foot control and a suction device. The endoscopic microdebrider is used in performing a partial tonsillectomy, by partially shaving the tonsils. This procedure entails eliminating the
385:
Significant post-operative primary bleeding occurs in 0.2–2.2% of people, and secondary bleeding in 0.1–3.3%. In several reported case series, the rate of post tonsillectomy bleeding ranged from 2.0% to 7.0%. Also in veterinary surgery, bleeding was a common complication. A meta-analysis reported
675:
procedure. A carbon dioxide laser is commonly used, and is swept over each tonsil 8–10 times. The smoke is aspirated out of the mouth to prevent smoke inhalation. Often, more than one procedure is required, each lasting about 20 minutes. Due to the frequent requirement for multiple sessions, this
776:
In
Germany tonsillectomy rates between regions differ by up to a factor of 8. A 2010 study in England found the annual tonsillectomy rate per 100,000 between 2000 and 2005 was 754 in the highest region, the national average was 304 and the lowest region was 102. This means there is a seven-fold
737:
begin sloughing off from the surgical sites. The overall risk of bleeding is approximately 1–2%. It is higher in adults, especially males over age 70 and three-quarters of bleeding incidents occur on the same day as the surgery. Approximately 3% of adults develop bleeding at this time which may
285:
review found moderate quality evidence for benefits in terms of quality of life and symptoms but no benefit in attention or academic performance. It recommended that physicians and parents should weigh the benefits and risks of surgery as OSA symptoms may spontaneously resolve over time. An
800:
In 2018, a study of the medical records of 1.6 million UK children found 15,760 had sufficient sore throats to justify tonsillectomy and 13.6% (2,144) underwent surgery. The same study found 18,281 children who had undergone tonsillectomy, and of these only 11.7% (2,144) had evidence-based
772:
There are variations in tonsillectomy rates, both between and within countries. In 2015, tonsillectomy rates in the
Netherlands, Belgium, Finland and Norway were at least twice those in the UK but rates in Spain, Italy and Poland were at least a quarter lower. Tonsillectomy rates even vary
1075:
Right now, doctors, a lot of times, are forced to make decisions based on the fee payment schedule that's out there. So if they're looking and – and you come in and you've got a bad sore throat, or your child has a bad sore throat, or has repeated sore throats, the doctor may look at the
691:, preventing injury, inflammation, and infection. The procedure results in less post-operative pain, a more rapid recovery, and perhaps fewer delayed complications. However, the partial tonsillectomy is suggested for enlarged tonsils—not those that incur repeated infections.
517:
It is not known whether the benefits of subtotal tonsillectomy in obstructive sleep apnea are enduring. But this is also the case for tonsillectomy for sleep apnea. There have been no randomised controlled trials of long term effectiveness of tonsillectomy for sleep apnea.
467:
720:
A sore throat will persist approximately two weeks following surgery while pain following the procedure is significant and may necessitate a hospital stay. Recovery can take from 7 to 10 days and proper hydration is very important during this time, since
1066:
reimbursements instead of a fixed salary. Regarding tonsillectomy, a 1968 Canadian study pointed out that ENT specialists working on a fee-for-service programme were twice as likely to perform a tonsillectomy than those who were not. In 2009 then
132:(OSA). For those with frequent throat infections, surgery results in 0.6 (95% confidence interval: 1.0 to 0.1) fewer sore throats in the following year, but there is no evidence of long term benefits. In children with OSA, it results in improved
155:
typically lasts about one to two weeks after surgery. Bleeding occurs in about 1% within the first day and another 2% after that. Between 1 in 2,360 and 1 in 56,000 procedures cause death. Tonsillectomy does not appear to affect long term
1125:(490 CE) recommended partial removal of the tonsil, writing "Those who extirpate the entire tonsil remove, at the same time, structures that are perfectly healthy, and, in this way, give rise to serious Hæmorrhage". In the 7th century
763:
Some surgeons recommend starting with a soft diet for two weeks before advancing to normal diet. This is to prevent any sharp foods from potentially irritating the tonsillar fossae during the healing stage and provoking a bleed.
676:
treatment may work out more expensive than a single session tonsillectomy. A degree of patient compliance is required, making it unsuitable for young children and anxious persons, who risk harm if they move during the procedure.
729:
of poor fluid intake. Tonsillectomy appears to be more painful in adults than children. Controlling the pain following tonsillectomy is important to ensure that people can start eating again normally following the procedure.
334:, some of which are serious. Complications are divided into primary (first 24 hours after surgery), and secondary (after 24 hours), with bleeding being the most common complication. Other common complications are
1129:(625–690) described a detailed procedure for tonsillectomy, including dealing with the inevitable post-operative bleeding. 1,200 years pass before the procedure is described again with such precision and detail.
4123:
Hastings JE, Mott FD, Hewitt D, Barclay A (July 1970). "An interim report on the Sault Ste. Marie study: a comparison of personal health services utilization. A joint Canada-World Health
Organization Project".
1203:
surgery for all but 65 of the remaining children. Complications were often simply accepted. The medical community considered enlarged tonsils a disease, attributing their enlargement to infection rather than a
760:(NSAIDs) may increase the risk of bleeding but evidence does not support such a risk. Further research is required to determine if mouth rinses, mouthwashes and sprays help improve recovery following surgery.
3444:"Regional Anaesthesia and Acute Pain, Paper No: 852.00: Do laser tonsillectomies need less opioids as compared to standard tonsillectomies: a retrospective comparison of peri-operative analgesic requirement"
268:
Many cases of the sore throat have other causes than tonsillitis and tonsillectomy is therefore not indicated for those cases. The diagnosis of tonsillitis is often made without testing for bacteria. The
198:
in the United States is US$ 4,400 as of 2013. There is some controversy as of 2019 as to when the surgery should be used. There are variations in the rates of tonsillectomy between and within countries.
1321:
Mitchell RB, Archer SM, Ishman SL, Rosenfeld RM, Coles S, Finestone SA, Friedman NR, Giordano T, Hildrew DM, Kim TW, Lloyd RM, Parikh SR, Shulman ST, Walner DL, Walsh SA, Nnacheta LC (5 February 2019).
1806:
Sun GH, Auger KA, Aliu O, Patrick SW, DeMonner S, Davis MM (December 2013). "Variation in inpatient tonsillectomy costs within and between US hospitals attributable to postoperative complications".
1427:
Adeno-/tonsillectomy leads to a reduction in the number of episodes of sore throat and days with sore throat in children in the first year after surgery compared to (initial) non-surgical treatment.
804:
Table: Numbers of children (from 1.6 million children between 2005 and 2016 in the UK) identified with possible indications for tonsillectomy and the numbers who subsequently undergo tonsillectomy.
595:
thermal ablation transfers radiofrequency energy to the tonsil tissue through probes inserted in the tonsil. The procedure can be performed in an office (outpatient) setting under light sedation or
4578:
220:
183:
may also be removed or shaved down, in which case it is known as an "adenotonsillectomy". The partial removal of the tonsils is called a "tonsillotomy", which may be preferred in cases of OSA.
1230:
concluded that there was insufficient evidence that the benefits of tonsillectomy outweighed the risks and therefore recommended more research, which subsequently led to stricter guidelines.
2771:
Albawaliz A, Fatima Z, Abonofal A, Abumoawad A, Al Momani L, Shrestha A (20 May 2020). "The association between tonsillectomy and
Hodgkin's lymphoma: A systematic review and meta-analysis".
1650:
Gorman D, Ogston S, Hussain SS (2017). "Improvement in symptoms of obstructive sleep apnoea in children following tonsillectomy versus tonsillotomy: a systematic review and meta-analysis".
1858:
2100:
Wilson JA, O'Hara J, Fouweather T, Homer T, Stocken DD, Vale L, Haighton C, Rousseau N, Wilson R, McSweeney L, Wilkes S, Morrison J, MacKenzie K, Ah-See K, Carrie S (17 June 2023).
1093:
Tonsillectomies have been practiced for over 2,000 years, with varying popularity over the centuries. The earliest mention of the procedure is in "Hindu medicine" from about 1000
2663:
Amin R, Mansabdar A, Gu H, Gangineni B, Mehta N, Patel H, Patel N, Laller S, Vinayak S, Abdulqader MA, Jain H, Rekhraj AS, Adimoulame H, Singh G, Moonjely Davis J (April 2024).
1164:
from the nose; it was assumed that removal of large amounts of tonsillar tissue would interfere with the ability to remove these secretions, causing them to accumulate in the
1211:, many surgeons believed that not only enlarged tonsils, but all tonsils should be removed. In the 1940s tonsillectomy became controversial as several studies linked it to
434:
if done before the age of 20. A meta-analysis published in 2020 indicated a statistically significant association between a history of tonsillectomy and the development of
3878:
Fedorowicz Z, van Zuuren EJ, Nasser M, Carter B, Al
Langawi JH (10 September 2013). "Oral rinses, mouthwashes and sprays for improving recovery following tonsillectomy".
4571:
2420:
Seshamani M, Vogtmann E, Gatwood J, Gibson TB, Scanlon D (April 2014). "Prevalence of Complications from Adult Tonsillectomy and Impact on Health Care Expenditures".
2102:"Conservative management versus tonsillectomy in adults with recurrent acute tonsillitis in the UK (NATTINA): a multicentre, open-label, randomised controlled trial"
273:
states that it is very rare that someone needs to have their tonsils taken out, and it is usually only necessary in case of severe tonsillitis that keeps recurring.
650:. The temperature of the surrounding tissue reaches 80 °C. Proponents of this procedure assert that the result is precise cutting with minimal thermal damage.
478:, a so-called total, or extra-capsular tonsillectomy. Problems including pain and bleeding led to a recent resurgence in interest in sub-total tonsillectomy or
1385:
4564:
4004:"Incidence of indications for tonsillectomy and frequency of evidence-based surgery: a 12-year retrospective cohort study of primary care electronic records"
2159:
390:
bleeding. Death occurs as a result in between 1 in 2,360 and 56,000 procedures. Bleeding accounts for one-third of deaths. As the procedure is done under
482:, which was popular 60 to 100 years ago, in an effort to reduce these complications. The generally accepted procedure for 'total' tonsillectomy uses a
1615:
Zhang LY, Zhong L, David M, Cervin A (December 2017). "Tonsillectomy or tonsillotomy? A systematic review for paediatric sleep-disordered breathing".
2814:
Kacimi SE, Elgenidy A, Cheema HA, Ould Setti M, Khosla AA, Benmelouka AY, Aloulou M, Djebabria K, Shamseldin LS, Riffi O, Mesli NS (20 July 2022).
3369:
Belloso A, Chidambaram A, Morar P, Timms MS (November 2003). "Coblation tonsillectomy versus dissection tonsillectomy: postoperative hemorrhage".
3277:
Khan I, Abelardo E, Scott NW, Shakeel M, Menakaya O, Jaramillo M, Mahmood K (February 2012). "Coblation tonsillectomy: is it inherently bloody?".
4530:
58:
54:
2607:"Systematic review with meta-analysis: environmental and dietary differences of inflammatory bowel disease in Eastern and Western populations"
1144:. This method was not popular with the patients due to the immense pain it caused and the infection that usually followed. Scottish physician
661:
almost no incidence of bleeding. Hospitals in the US are advertising this procedure as "Painless Tonsillectomy". Also known as Tissue Welding.
4346:
3686:
3659:
3628:
777:
difference between the region with the highest tonsillectomy rate and the region with the lowest one. In 2006, English Chief Medical Officer
2934:"Systematic review of randomized controlled trials comparing intracapsular tonsillectomy with total tonsillectomy in a pediatric population"
1233:
As doctors took a more conservative approach towards tonsillectomy, parental pressure became one of the most important reasons for surgery.
190:. In the United States, as of 2010, tonsillectomy is performed less frequently than in the 1970s although it remains the second most common
4860:
541:: Removal of the tonsils by use of a forceps and scissors with a wire loop called a snare was formerly the most common method practiced by
3475:
2385:
Galindo Torres BP, De Miguel García F, Whyte Orozco J (June 2018). "Tonsillectomy in adults: Analysis of indications and complications".
2517:"Complications of canine tonsillectomy by clamping technique combined with monopolar electrosurgery – a retrospective study of 39 cases"
1763:
Lamprell L, Ahluwalia S (April 2015). "Who has been hiding in your tonsillectomy tray? Eponymous instruments in tonsillectomy surgery".
757:
3917:
2665:"Mucosa-Associated Lymphoid Tissue Surgeries as a Possible Risk for Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis"
1894:"Exploring the variation in paediatric tonsillectomy rates between English regions: a 5-year NHS and independent sector data analysis"
1528:
Bitar MA, Dowli A, Mourad M (August 2015). "The effect of tonsillectomy on the immune system: A systematic review and meta-analysis".
256:
1509:
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whereby using the finger (or a blunt hook if necessary), the tonsil was separated from the neighboring tissue before being cut out.
709:
335:
733:
At some point, most commonly 7 to 11 days after the surgery (but occasionally as long as two weeks after), bleeding can occur when
3146:"Coblation vs. Electrocautery Tonsillectomy: A Prospective Randomized Study Comparing Clinical Outcomes in Adolescents and Adults"
792:
The rise in adenotonsillectomies for sleep apnea in the USA has been greater than the decline in tonsillectomies for sore throat.
3058:
Friedman M, LoSavio P, Ibrahim H, Ramakrishnan V (May 2003). "Radiofrequency tonsil reduction: safety, morbidity, and efficacy".
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obstructive portion of the tonsil while preserving the tonsillar capsule. A natural biologic dressing is left in place over the
290:
review however did find improvements at school. The procedure is recommended for those who have OSA that has been verified by a
3033:
2468:"Postoperative Bleeding and Associated Utilization following Tonsillectomy in Children: A Systematic Review and Meta-analysis"
3786:
Windfuhr JP, Chen YS, Remmert S (February 2005). "Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients".
3234:
Walner DL, Miller SP, Villines D, Bussell GS (October 2012). "Coblation tonsillectomy in children: incidence of bleeding".
1448:"Tonsillectomy or adenotonsillectomy versus non-surgical management for obstructive sleep-disordered breathing in children"
442:. The relationship between childhood tonsillectomy and the development of other cancer types in adulthood remains unclear.
1227:
191:
4875:
2566:
Ingram DG, Friedman NR (December 2015). "Toward Adenotonsillectomy in Children: A Review for the General Pediatrician".
3412:
109:
1568:"Long-term effects of adenotonsillectomy in children with obstructive sleep apnoea: protocol for a systematic review"
4051:
Shafrin J (May 2010). "Operating on commission: analyzing how physician financial incentives affect surgery rates".
4835:
295:
4668:
474:
For the past 50 years at least, tonsillectomy has been performed by dissecting the tonsil from its surrounding
236:
65:
438:. A meta-analysis from 2022 concluded that a history of tonsillectomy is associated with an increased risk of
1140:(1509) wrote it to be "a bad operation" and suggested a procedure that involved gradual strangulation with a
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concentrations after tonsillectomy but these are of unclear significance. Tonsillectomy is a risk factor for
4766:
4724:
3702:
Graumüller S, Laudien B (2003). "Postoperative pain after tonsillectomy—comparison of children and adults".
1110:
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is less prominent. This procedure is recommended for treating enlarged tonsils and not chronic or recurrent
331:
282:
270:
129:
4539:
1386:"Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis"
4870:
4698:
2334:
Kim BY, Lee SJ, Yun JH, Bae JH (1 August 2020). "Taste Dysfunction after Tonsillectomy: A Meta-analysis".
1941:
Witsell DL, Orvidas LJ, Stewart MG, Hannley MT, Weaver EM, Yueh B, Smith TL, Goldstein NA (January 2008).
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of 1.93 and 1.24, respectively. There is an association suggesting an increase in the risk of developing
2722:"Surgery and risk for multiple sclerosis: a systematic review and meta-analysis of case-control studies"
216:
4527:
4470:
4545:
2816:"Prior Tonsillectomy and the Risk of Breast Cancer in Females: A Systematic Review and Meta-analysis"
1212:
1145:
363:
2281:"Tonsil size and outcome of uvulopalatopharyngoplasty with tonsillectomy in obstructive sleep apnea"
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1942:
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2445:
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2316:
2175:
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1978:
1923:
1831:
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682:: The microdebrider is a powered rotary shaving device with continuous suction often used during
569:: Electrocautery uses electrical energy to separate the tonsillar tissue and assists in reducing
550:
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423:
315:
228:
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According to a study from 2009, surgery rates on average increase by 78% when surgeons are paid
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3944:"Changes and consistencies in the epidemiology of pediatric adenotonsillar surgery, 1996–2006"
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2308:
2300:
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2141:
2133:
2082:
2074:
2025:
2017:
1970:
1962:
1915:
1823:
1780:
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1727:
1675:
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1597:
1545:
1505:
1480:
1418:
1345:
726:
224:
125:
49:
3831:"Nonsteroidal anti-inflammatory drugs and perioperative bleeding in paediatric tonsillectomy"
2466:
Francis DO, Fonnesbeck C, Sathe N, McPheeters M, Krishnaswami S, Chinnadurai S (March 2017).
2280:
1997:
4635:
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4270:
4262:
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4015:
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3333:
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2429:
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2123:
2113:
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2009:
1954:
1905:
1815:
1772:
1735:
1719:
1659:
1624:
1587:
1579:
1537:
1470:
1462:
1408:
1400:
1335:
623:
596:
542:
503:
495:
435:
2206:"Tonsillectomy Versus Watchful Waiting for Recurrent Throat Infection: A Systematic Review"
1446:
Venekamp RP, Hearne BJ, Chandrasekharan D, Blackshaw H, Lim J, Schilder AG (October 2015).
386:
that frequency of bleeding after tonsillectomy across different techniques did not differ.
4865:
4534:
1126:
1063:
683:
553:; the tonsils are completely removed and the remaining tissue surface is cauterized. The
545:, but has been largely replaced in favor of other techniques. The procedure requires the
411:
375:
133:
113:
756:
is not recommended for those less than 12 years old. There is a theoretical concern that
171:(acetaminophen) may be used to treat postoperative pain. The surgery is often done using
3596:
3563:
3511:
3195:"Coblation versus traditional tonsillectomy: A double blind randomized controlled trial"
2784:
2697:
1498:
Flint PW, Haughey BH, Robbins KT, Thomas JR, Niparko JK, Lund VJ, Lesperance MM (2014).
450:
4806:
4275:
4250:
4215:
4198:
4100:
4087:
4028:
4003:
3855:
3830:
3763:
3730:
3676:
3536:
3346:
3321:
3211:
3194:
3170:
3145:
3010:
2977:
2909:
2874:
2850:
2815:
2748:
2721:
2543:
2516:
2492:
2467:
2230:
2205:
2160:"Removing tonsils is effective and cost-effective for adults with frequent tonsillitis"
1740:
1707:
1592:
1567:
1475:
1413:
1226:
Tonsillectomy rates in the United States have declined since 1978, when experts of the
1177:
1117:(121–200 CE) was the first to advocate the use of the surgical instrument known as the
778:
701:
657:
628:
592:
582:
565:
531:
487:
379:
319:
176:
4380:
4363:
3715:
2118:
2101:
1085:
466:
4854:
4794:
4510:
3382:
3263:
3071:
2800:
2646:
2579:
2371:
2179:
1943:"Quality of life after tonsillectomy in adults with recurrent or chronic tonsillitis"
1910:
1893:
1220:
1188:
1137:
734:
705:
574:
439:
419:
403:
307:
240:
232:
157:
3977:
3562:
Dhiwakar M, Clement WA, Supriya M, McKerrow W (12 December 2012). Dhiwakar M (ed.).
3322:"Hemorrhage rate after coblation tonsillectomy: a meta-analysis of published trials"
3306:
3087:
2320:
2037:
1927:
1835:
1792:
4761:
4640:
4405:
3887:
3846:
3815:
3579:
3527:
3398:
3130:
2993:
1687:
1466:
1404:
1216:
1169:
1098:
1068:
782:
646:, the vibration transfers energy to the tissue, providing simultaneous cutting and
615:
371:
4199:"A History of Tonsillectomy: Two Millennia of Trauma, Haemorrhage and Controversy"
2449:
1982:
85:
4486:
3960:
3943:
3799:
1958:
1819:
1628:
1541:
454:
Cryptic tonsils immediately following surgical removal (bilateral tonsillectomy).
71:
4673:
4603:
4591:
2052:
1583:
1133:
746:
722:
647:
605:
511:
351:
339:
291:
212:
208:
168:
152:
148:
121:
79:
2891:
2533:
2171:
2053:"Impact of tonsillectomy on quality of life in adults with chronic tonsillitis"
2013:
350:
and trouble talking. In rare cases, tonsillectomy may also cause damage to the
4739:
3746:
3337:
3290:
3114:
2398:
1776:
1204:
1106:
672:
668:
632:
427:
311:
281:
Tonsillectomy improves obstructive sleep apnea (OSA) in most children. A 2015
30:
4494:
4389:
4163:
3895:
3754:
3587:
3001:
2900:
2841:
2832:
2792:
2688:
2630:
2483:
2433:
2355:
2347:
2304:
2253:
2204:
Morad A, Sathe NA, Francis DO, McPheeters ML, Chinnadurai S (February 2017).
2137:
2078:
2021:
1966:
1731:
1671:
1340:
1323:
4817:
3420:
3161:
2950:
2933:
2738:
2606:
2051:
Schwentner I, Höfer S, Schmutzhard J, Deibl M, Sprinzl GM (11 August 2007).
1161:
742:
643:
635:
491:
407:
347:
195:
164:
4502:
4397:
4284:
4224:
4109:
4072:
4037:
3969:
3903:
3864:
3807:
3772:
3731:"Perioperative local anaesthesia for reducing pain following tonsillectomy"
3605:
3545:
3390:
3355:
3298:
3255:
3220:
3179:
3122:
3079:
3019:
2959:
2918:
2859:
2757:
2706:
2638:
2587:
2552:
2501:
2441:
2406:
2363:
2312:
2239:
2221:
2145:
2086:
2069:
2029:
1974:
1919:
1827:
1784:
1749:
1679:
1636:
1601:
1549:
1484:
1422:
1349:
1219:. In the media, tonsillectomy was criticised for being "fashionable" or a "
1160:. At the time, the function of the tonsils was thought to be absorption of
534:. However, there are other techniques and a brief review of each follows:
458:
35:
Typical appearance of the back of the throat three days post tonsillectomy.
4419:
4137:
4019:
3476:"Interventional procedure overview of laser assisted serial tonsillectomy"
502:
have also been used. Bleeding is stopped with electrocautery, ligation by
4630:
4420:"The Immunological Basis for Immunization Series Module 6: Poliomyelitis"
3460:
3443:
2605:, Zhuang X, Tian Z, Li X, Ma R, Mao R, Qiu Y, Chen M (24 November 2021).
600:
558:
507:
343:
180:
144:
140:
4443:
3829:
Lewis SR, Nicholson A, Cardwell ME, Siviter G, Smith AF (18 July 2013).
3193:
Omrani M, Barati B, Omidifar N, Okhovvat AR, Hashemi SA (January 2012).
1566:
Damiani F, Rada G, Gana JC, Brockmann PE, Alberti G (2 September 2016).
4711:
4595:
4266:
3247:
2296:
2128:
1148:
in 1600 summarized the three methods in use at the time, including the
753:
578:
554:
546:
527:
483:
359:
3510:
Steward DL, Grisel J, Meinzen-Derr J (August 2011). Steward DL (ed.).
2622:
2461:
2459:
1998:"Economic Benefit of Tonsillectomy in Adults with Chronic Tonsillitis"
1859:"Surgical operations and procedures statistics - Statistics Explained"
1723:
1663:
95:
4778:
4750:
4652:
4064:
3512:"Steroids for improving recovery following tonsillectomy in children"
1173:
1165:
750:
585:. This may result in more discomfort during the postoperative period.
475:
410:
in other areas of the body. Some studies have found small changes in
355:
117:
2680:
382:. Throat pain typically lasts about one to two weeks after surgery.
3320:
Mösges R, Hellmich M, Allekotte S, Albrecht K, Böhm M (June 2011).
810:
Condition which might be considered an indication for tonsillectomy
354:(because of the clamp that is placed in the mouth during surgery),
186:
The surgery has been described since at least as early as 50 AD by
4685:
4251:"'A Wicked Operation'? Tonsillectomy in Twentieth-Century Britain"
1192:
1114:
1084:
570:
514:. The most effective surgical approach has not been well studied.
499:
465:
457:
449:
1324:"Clinical Practice Guideline: Tonsillectomy in Children (Update)"
1195:; the instrument, known as the tonsil guillotine (and later as a
854:
Aphthous stomatitis, pharyngitis & cervical adenitis syndrome
1712:
GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery
422:
found that tonsillectomy is associated with Crohn's disease and
287:
4560:
4364:"Polio provocation: solving a mystery with the help of history"
1384:
Burton MJ, Glasziou PP, Chong LY, Venekamp RP (November 2014).
577:. Research has shown that the heat of electrocautery (400
4614:
4546:"Clinical UM Guideline CG-SURG-30: Tonsillectomy for Children"
1094:
639:
257:
American Academy of Otolaryngology & Head and Neck Surgery
4088:"Tonsillectomy and Adenoidectomy: A Review of the Literature"
221:
periodic fever, aphthous stomatitis, pharyngitis and adenitis
2875:"Tonsillectomy and the incidence of various types of cancer"
4471:"Tonsillectomy and poliomyelitis: Development of causality"
3481:. National institute of clinical excellence. Archived from
2515:
Turkki OM, Bergman CE, Lee MH, Höglund OV (December 2022).
239:. For children, tonsillectomy is usually combined with the
3918:"Billions of NHS money wasted on 'ineffective' operations"
781:
revealed that unnecessary tonsillectomies and unnecessary
330:
While generally safe, tonsillectomy may result in several
926:
Recurrent sore throats / tonsillitis (episodes per year):
4002:Šumilo D, Nichols L, Ryan R, Marshall T (January 2019).
1892:
Suleman M, Clark MP, Goldacre M, Burton M (April 2010).
4469:
Kohanzadeh A, Somogyi DZ, Kravitz MB (19 August 2022).
1187:
modified an existing instrument originally designed by
4475:
International Journal of Pediatric Otorhinolaryngology
3144:
Hong SM, Cho JG, Chae SW, Lee HM, Woo JS (June 2013).
2932:
Walton J, Ebner Y, Stewart MG, April MM (March 2012).
1617:
International Journal of Pediatric Otorhinolaryngology
1530:
International Journal of Pediatric Otorhinolaryngology
1501:
Cummings Otolaryngology – Head and Neck Surgery E-Book
671:, LAST can be performed under local anesthetic as an
406:. It does not appear to affect the long term risk of
402:
There is no evidence tonsillectomy affects long term
4341:. Oxford University Press/Books. 2001. p. 815.
3564:"Antibiotics to reduce post-tonsillectomy morbidity"
4803:
4775:
4747:
4738:
4708:
4682:
4649:
4611:
4602:
78:
64:
48:
40:
23:
2938:Archives of Otolaryngology–Head & Neck Surgery
120:. The procedure is mainly performed for recurrent
306:There is no good evidence for other uses such as
3442:Randive S, Stevens B, Dilkes M, Mehta V (2012).
2976:Pinder DK, Wilson H, Hilton MP (16 March 2011).
2720:Lunny C, Knopp-Sihota JA, Fraser SN (May 2013).
139:While generally safe, complications may include
2978:"Dissection versus diathermy for tonsillectomy"
1073:
298:with tonsillectomy increases with tonsil size.
294:. Studies have shown that treatment success of
261:
4192:
4190:
4188:
4186:
4184:
4182:
4180:
3997:
3995:
3993:
3991:
3989:
3987:
2336:Annals of Otology, Rhinology & Laryngology
2002:Annals of Otology, Rhinology & Laryngology
961: 2 to 4 with guttate / chronic psoriasis
581:) may result in thermal injury to surrounding
194:in children. The typical cost when done as an
4572:
4550:Blue Cross Blue Shield Association of Georgia
4302:"Why More Children Are Keeping Their Tonsils"
3650:. Lippincott Williams & Wilkins. p.
3505:
3503:
3150:Clinical and Experimental Otorhinolaryngology
1379:
1121:, a practice that was to become common until
530:is the preferred surgical instrument of many
8:
1996:Bhattacharyya N, Kepnes LJ (November 2002).
1377:
1375:
1373:
1371:
1369:
1367:
1365:
1363:
1361:
1359:
741:Recommendations for pain management include
3880:The Cochrane Database of Systematic Reviews
3835:The Cochrane Database of Systematic Reviews
3735:The Cochrane Database of Systematic Reviews
3568:The Cochrane Database of Systematic Reviews
3516:The Cochrane Database of Systematic Reviews
2982:The Cochrane Database of Systematic Reviews
2199:
2197:
2195:
2193:
2191:
2189:
1455:The Cochrane Database of Systematic Reviews
1393:The Cochrane Database of Systematic Reviews
4744:
4608:
4579:
4565:
4557:
3326:European Archives of Oto-Rhino-Laryngology
3279:European Archives of Oto-Rhino-Laryngology
2611:Alimentary Pharmacology & Therapeutics
1887:
1885:
1883:
1881:
1879:
1504:. Elsevier Health Sciences. p. 2862.
1316:
1314:
1312:
1310:
1308:
1306:
1304:
1302:
1300:
1298:
1296:
1294:
1292:
1290:
1288:
1286:
1284:
1282:
1280:
1278:
1276:
1274:
1272:
1270:
1268:
1266:
29:
4379:
4274:
4214:
4099:
4027:
3959:
3942:Bhattacharyya N, Lin HW (November 2010).
3854:
3762:
3595:
3535:
3459:
3345:
3210:
3169:
3009:
2949:
2908:
2890:
2849:
2831:
2747:
2737:
2696:
2542:
2532:
2491:
2229:
2127:
2117:
2068:
1909:
1853:
1851:
1849:
1847:
1845:
1739:
1708:"Tonsillitis and sore throat in children"
1701:
1699:
1697:
1591:
1561:
1559:
1523:
1521:
1474:
1441:
1439:
1437:
1435:
1412:
1339:
1264:
1262:
1260:
1258:
1256:
1254:
1252:
1250:
1248:
1246:
738:sometimes require surgical intervention.
4338:Oxford Illustrated Companion to Medicine
3729:Hollis LJ, Burton MJ, Millar JM (2000).
3619:Graham JM, Scadding GK, Bull PD (2008).
806:
4008:The British Journal of General Practice
3199:Journal of Research in Medical Sciences
1242:
725:can increase throat pain, leading to a
708:may be given during surgery to prevent
557:will leave with minimal post-operative
470:Throat some days after a tonsillectomy.
207:Tonsillectomy is mainly undertaken for
151:, trouble eating, and trouble talking.
116:are fully removed from the back of the
3413:"COBLATION Tonsillectomy – My Tonsils"
1765:The Journal of Laryngology and Otology
1136:saw tonsillectomy fall into disfavor;
20:
4331:
4329:
4327:
4325:
4323:
4296:
4294:
4244:
4242:
4240:
4238:
4236:
4234:
3647:Introductory medical-surgical nursing
3557:
3555:
2971:
2969:
2658:
2656:
975: 2 to 4 with glomerulonephritis
7:
3948:Otolaryngology–Head and Neck Surgery
3788:Otolaryngology–Head and Neck Surgery
3644:Timby BK, Nancy Ellen Smith (2006).
2472:Otolaryngology–Head and Neck Surgery
2422:Otolaryngology–Head and Neck Surgery
1947:Otolaryngology–Head and Neck Surgery
1328:Otolaryngology–Head and Neck Surgery
758:NonSteroidal Anti-Inflammatory Drugs
599:. After the treatment is performed,
3034:"COBLATION Plasma Technology – ENT"
2785:10.1200/JCO.2020.38.15_suppl.e20015
1172:. For this reason, physicians like
656:: A new technology which uses pure
462:Throat 1 day after a tonsillectomy.
91:
3038:Smith & Nephew US Professional
1097:. Roughly a millennium later, the
638:of its blade at a frequency of 55
14:
4126:Canadian Journal of Public Health
532:ear, nose, and throat specialists
336:postoperative nausea and vomiting
3383:10.1097/00005537-200311000-00029
3072:10.1097/00005537-200305000-00020
2580:10.1001/jamapediatrics.2015.2016
1911:10.1111/j.1749-4486.2010.02086.x
896:Other sleep disordered breathing
4152:"Obama's Fifth News Conference"
787:British National Health Service
16:Surgical removal of the tonsils
4094:. 1977 Sep, 23: 113, 115–117.
3888:10.1002/14651858.CD007806.pub4
3847:10.1002/14651858.CD003591.pub3
3580:10.1002/14651858.CD005607.pub4
3528:10.1002/14651858.CD003997.pub2
3448:British Journal of Anaesthesia
2994:10.1002/14651858.CD002211.pub2
1467:10.1002/14651858.CD011165.pub2
1405:10.1002/14651858.CD001802.pub3
394:, there are anesthesia risks.
1:
4381:10.1016/S0140-6736(14)61251-4
3716:10.1016/S0531-5131(03)01073-2
3704:International Congress Series
2873:Holló G (15 September 2021).
2279:Tschopp S, Tschopp K (2019).
2119:10.1016/S0140-6736(23)00519-6
1706:Stelter K (1 December 2014).
1228:National Institutes of Health
215:. It is also carried out for
192:outpatient surgical procedure
4487:10.1016/j.ijporl.2022.111290
4362:Mawdsley SE (26 July 2014).
3961:10.1016/j.otohns.2010.06.918
3800:10.1016/j.otohns.2004.09.007
3101:Windfuhr JP (May 2007). "".
2773:Journal of Clinical Oncology
1959:10.1016/j.otohns.2007.08.015
1820:10.1097/MLR.0b013e3182a50325
1629:10.1016/j.ijporl.2017.10.008
1542:10.1016/j.ijporl.2015.05.016
4861:Surgical removal procedures
1584:10.1136/bmjopen-2015-010030
1054:Source: Šumilo et al. 2018
539:Dissection and snare method
44:Adenotonsillectomy, T&A
4892:
4203:The Ulster Medical Journal
2892:10.1007/s12026-021-09230-3
2534:10.1186/s12917-022-03342-0
2172:10.3310/nihrevidence_59646
2014:10.1177/000348940211101106
796:Evidence-based indications
789:21 million pounds a year.
271:UK National Health Service
4836:Uvulopalatopharyngoplasty
4831:
4444:"Polio | LCI richtlijnen"
4249:Dwyer-Hemmings L (2018).
3747:10.1002/14651858.CD001874
3623:. Springer. p. 136.
3338:10.1007/s00405-011-1535-9
3291:10.1007/s00405-011-1609-8
3115:10.1007/s00106-006-1523-3
2669:Gastroenterology Research
2399:10.1016/j.anl.2017.08.012
1777:10.1017/S0022215114003016
1209:theory of focal infection
642:. Invisible to the naked
510:, a protein that induces
506:, and the topical use of
296:uvulopalatopharyngoplasty
211:and recurrent or chronic
92:
28:
4669:Genioglossus advancement
4540:History of tonsillectomy
4528:Tonsillectomy Procedures
4197:McNeill RA (June 1960).
2833:10.3389/fonc.2022.925596
2484:10.1177/0194599816683915
2434:10.1177/0194599813519972
2348:10.1177/0003489420946770
1341:10.1177/0194599818801757
1180:censured the procedure.
1017:No indication identified
237:diphtheria carrier state
4767:Pharyngeal flap surgery
4725:Template:Periodontology
3678:Mayo Clinic diet manual
3162:10.3342/ceo.2013.6.2.90
2951:10.1001/archoto.2012.16
2739:10.1186/1471-2377-13-41
2521:BMC Veterinary Research
1898:Clinical Otolaryngology
1652:Clinical Otolaryngology
882:Obstructive sleep apnea
710:post-operative vomiting
612:Coblation tonsillectomy
589:Radiofrequency ablation
277:Obstructive sleep apnea
163:Following the surgery,
130:obstructive sleep apnea
4699:Template:Endodontology
2222:10.1542/peds.2016-3490
2070:10.4414/smw.2007.11735
1103:Aulus Cornelius Celsus
1090:
1078:
486:and blunt dissection,
471:
463:
455:
368:respiratory compromise
266:
259:(AAO-HNS) recommended:
241:removal of the adenoid
4020:10.3399/bjgp18X699833
3675:Pemberton CM (1988).
2820:Frontiers in Oncology
1088:
910:Peritonsillar abscess
749:(acetaminophen). The
700:A single dose of the
469:
461:
453:
217:peritonsillar abscess
2879:Immunologic Research
2779:(15_suppl): e20015.
2166:. 5 September 2023.
2112:(10393): 2051–2059.
2057:Swiss Medical Weekly
1213:bulbar poliomyelitis
1205:physiologic response
1058:Financial incentives
665:Carbon dioxide laser
4876:Otorhinolaryngology
4533:5 July 2008 at the
1334:(1_suppl): S1–S42.
1185:Philip Syng Physick
1183:In 1828, physician
4664:Lingual frenectomy
4267:10.1017/mdh.2018.5
4156:The New York Times
4086:Naylor NL (1977).
3488:on 4 December 2013
3461:10.1093/bja/aer489
3248:10.1002/lary.23526
2387:Auris Nasus Larynx
2297:10.1002/lary.27899
1091:
1089:Tonsil guillotine.
1069:US President Obama
813:Number of children
785:combined cost the
689:pharyngeal muscles
551:general anesthesia
472:
464:
456:
446:Surgical procedure
432:multiple sclerosis
424:ulcerative colitis
392:general anesthesia
342:, trouble eating,
316:trouble swallowing
229:airway obstruction
110:surgical procedure
4848:
4847:
4844:
4843:
4823:Uvulopalatoplasty
4734:
4733:
4626:Labial frenectomy
4374:(9940): 300–301.
4348:978-0-19-262950-0
4306:Los Angeles Times
4092:Can Fam Physician
3688:978-1-55664-032-2
3661:978-0-7817-8032-2
3630:978-3-540-69930-9
2623:10.1111/apt.16703
2291:(12): E449–E454.
2260:. 23 October 2017
2063:(3132): 454–461.
1724:10.3205/cto000110
1664:10.1111/coa.12717
1207:. Because of the
1191:for removing the
1052:
1051:
868:Paradise criteria
829:Proportion of all
716:Post-surgery care
543:otolaryngologists
496:Harmonic scalpels
436:Hodgkin's disease
348:taste dysfunction
225:guttate psoriasis
173:metal instruments
126:throat infections
103:
102:
4883:
4811:
4783:
4755:
4745:
4716:
4690:
4657:
4636:Lip augmentation
4619:
4609:
4590:relating to the
4581:
4574:
4567:
4558:
4553:
4515:
4514:
4466:
4460:
4459:
4457:
4455:
4440:
4434:
4433:
4431:
4429:
4424:
4416:
4410:
4409:
4383:
4359:
4353:
4352:
4333:
4318:
4317:
4315:
4313:
4298:
4289:
4288:
4278:
4246:
4229:
4228:
4218:
4194:
4175:
4174:
4172:
4170:
4158:. 22 July 2009.
4148:
4142:
4141:
4120:
4114:
4113:
4103:
4083:
4077:
4076:
4065:10.1002/hec.1495
4053:Health Economics
4048:
4042:
4041:
4031:
4014:(678): e33–e41.
3999:
3982:
3981:
3963:
3939:
3933:
3932:
3930:
3928:
3922:Evening Standard
3914:
3908:
3907:
3875:
3869:
3868:
3858:
3826:
3820:
3819:
3783:
3777:
3776:
3766:
3726:
3720:
3719:
3699:
3693:
3692:
3672:
3666:
3665:
3641:
3635:
3634:
3616:
3610:
3609:
3599:
3559:
3550:
3549:
3539:
3507:
3498:
3497:
3495:
3493:
3487:
3480:
3472:
3466:
3465:
3463:
3439:
3433:
3432:
3430:
3428:
3419:. Archived from
3409:
3403:
3402:
3371:The Laryngoscope
3366:
3360:
3359:
3349:
3317:
3311:
3310:
3274:
3268:
3267:
3236:The Laryngoscope
3231:
3225:
3224:
3214:
3190:
3184:
3183:
3173:
3141:
3135:
3134:
3098:
3092:
3091:
3060:The Laryngoscope
3055:
3049:
3048:
3046:
3044:
3030:
3024:
3023:
3013:
2973:
2964:
2963:
2953:
2929:
2923:
2922:
2912:
2894:
2870:
2864:
2863:
2853:
2835:
2811:
2805:
2804:
2768:
2762:
2761:
2751:
2741:
2717:
2711:
2710:
2700:
2660:
2651:
2650:
2601:Zhao M, Feng R,
2598:
2592:
2591:
2563:
2557:
2556:
2546:
2536:
2512:
2506:
2505:
2495:
2463:
2454:
2453:
2417:
2411:
2410:
2382:
2376:
2375:
2331:
2325:
2324:
2285:The Laryngoscope
2276:
2270:
2269:
2267:
2265:
2250:
2244:
2243:
2233:
2216:(2): e20163490.
2201:
2184:
2183:
2156:
2150:
2149:
2131:
2121:
2097:
2091:
2090:
2072:
2048:
2042:
2041:
1993:
1987:
1986:
1938:
1932:
1931:
1913:
1889:
1874:
1873:
1871:
1869:
1855:
1840:
1839:
1803:
1797:
1796:
1760:
1754:
1753:
1743:
1703:
1692:
1691:
1647:
1641:
1640:
1612:
1606:
1605:
1595:
1563:
1554:
1553:
1525:
1516:
1515:
1495:
1489:
1488:
1478:
1461:(10): CD011165.
1452:
1443:
1430:
1429:
1416:
1399:(11): CD001802.
1390:
1381:
1354:
1353:
1343:
1318:
840:Tonsillar tumour
835:this indication
807:
624:Harmonic scalpel
597:local anesthesia
114:palatine tonsils
96:edit on Wikidata
88:
74:
33:
21:
4891:
4890:
4886:
4885:
4884:
4882:
4881:
4880:
4851:
4850:
4849:
4840:
4827:
4804:
4799:
4776:
4771:
4748:
4730:
4709:
4704:
4683:
4678:
4650:
4645:
4612:
4598:
4585:
4544:
4535:Wayback Machine
4524:
4519:
4518:
4468:
4467:
4463:
4453:
4451:
4448:LCI richtlijnen
4442:
4441:
4437:
4427:
4425:
4422:
4418:
4417:
4413:
4361:
4360:
4356:
4349:
4335:
4334:
4321:
4311:
4309:
4300:
4299:
4292:
4248:
4247:
4232:
4196:
4195:
4178:
4168:
4166:
4150:
4149:
4145:
4122:
4121:
4117:
4085:
4084:
4080:
4050:
4049:
4045:
4001:
4000:
3985:
3941:
3940:
3936:
3926:
3924:
3916:
3915:
3911:
3882:(9): CD007806.
3877:
3876:
3872:
3841:(7): CD003591.
3828:
3827:
3823:
3785:
3784:
3780:
3741:(2): CD001874.
3728:
3727:
3723:
3701:
3700:
3696:
3689:
3681:. B.C. Decker.
3674:
3673:
3669:
3662:
3643:
3642:
3638:
3631:
3618:
3617:
3613:
3561:
3560:
3553:
3522:(8): CD003997.
3509:
3508:
3501:
3491:
3489:
3485:
3478:
3474:
3473:
3469:
3454:: ii387–ii437.
3441:
3440:
3436:
3426:
3424:
3423:on 14 July 2016
3411:
3410:
3406:
3368:
3367:
3363:
3319:
3318:
3314:
3276:
3275:
3271:
3233:
3232:
3228:
3192:
3191:
3187:
3143:
3142:
3138:
3100:
3099:
3095:
3057:
3056:
3052:
3042:
3040:
3032:
3031:
3027:
2988:(3): CD002211.
2975:
2974:
2967:
2931:
2930:
2926:
2872:
2871:
2867:
2813:
2812:
2808:
2770:
2769:
2765:
2719:
2718:
2714:
2681:10.14740/gr1672
2662:
2661:
2654:
2600:
2599:
2595:
2574:(12): 1155–61.
2568:JAMA Pediatrics
2565:
2564:
2560:
2514:
2513:
2509:
2465:
2464:
2457:
2419:
2418:
2414:
2384:
2383:
2379:
2333:
2332:
2328:
2278:
2277:
2273:
2263:
2261:
2252:
2251:
2247:
2203:
2202:
2187:
2158:
2157:
2153:
2099:
2098:
2094:
2050:
2049:
2045:
2008:(11): 983–988.
1995:
1994:
1990:
1940:
1939:
1935:
1891:
1890:
1877:
1867:
1865:
1857:
1856:
1843:
1814:(12): 1048–54.
1805:
1804:
1800:
1762:
1761:
1757:
1705:
1704:
1695:
1649:
1648:
1644:
1614:
1613:
1609:
1565:
1564:
1557:
1527:
1526:
1519:
1512:
1497:
1496:
1492:
1450:
1445:
1444:
1433:
1388:
1383:
1382:
1357:
1320:
1319:
1244:
1239:
1168:, resulting in
1127:Paulus Aegineta
1083:
1064:fee-for-service
1060:
834:
833:attributable to
832:
831:tonsillectomies
830:
825:
823:
822:this indication
821:
820:Proportion with
817:this indication
816:
815:consulting with
814:
798:
770:
718:
698:
654:Thermal Welding
524:
448:
416:Crohn's disease
404:immune function
400:
376:laryngeal edema
360:pharyngeal wall
328:
304:
279:
249:
205:
158:immune function
134:quality of life
99:
84:
70:
36:
17:
12:
11:
5:
4889:
4887:
4879:
4878:
4873:
4868:
4863:
4853:
4852:
4846:
4845:
4842:
4841:
4839:
4838:
4832:
4829:
4828:
4826:
4825:
4820:
4814:
4812:
4801:
4800:
4798:
4797:
4792:
4786:
4784:
4773:
4772:
4770:
4769:
4764:
4758:
4756:
4742:
4736:
4735:
4732:
4731:
4729:
4728:
4719:
4717:
4706:
4705:
4703:
4702:
4693:
4691:
4680:
4679:
4677:
4676:
4671:
4666:
4660:
4658:
4647:
4646:
4644:
4643:
4638:
4633:
4628:
4622:
4620:
4606:
4600:
4599:
4586:
4584:
4583:
4576:
4569:
4561:
4555:
4554:
4542:
4537:
4523:
4522:External links
4520:
4517:
4516:
4461:
4435:
4411:
4354:
4347:
4319:
4290:
4261:(2): 217–241.
4230:
4176:
4143:
4115:
4078:
4043:
3983:
3934:
3909:
3870:
3821:
3778:
3721:
3694:
3687:
3667:
3660:
3636:
3629:
3611:
3551:
3499:
3467:
3434:
3417:My Tonsils.com
3404:
3377:(11): 2010–3.
3361:
3312:
3269:
3242:(10): 2330–6.
3226:
3185:
3136:
3093:
3050:
3025:
2965:
2924:
2885:(6): 467–470.
2865:
2806:
2763:
2712:
2652:
2617:(3): 266–276.
2593:
2558:
2507:
2478:(3): 442–455.
2455:
2428:(4): 574–581.
2412:
2393:(3): 517–521.
2377:
2342:(2): 205–210.
2326:
2271:
2245:
2185:
2151:
2092:
2043:
1988:
1933:
1875:
1841:
1798:
1755:
1693:
1658:(2): 275–282.
1642:
1607:
1578:(9): e010030.
1555:
1536:(8): 1184–91.
1517:
1510:
1490:
1431:
1355:
1241:
1240:
1238:
1235:
1217:social classes
1178:Lorenz Heister
1109:) described a
1082:
1079:
1059:
1056:
1050:
1049:
1044:
1039:
1034:
1028:
1027:
1024:
1021:
1018:
1014:
1013:
1010:
1007:
1004:
1000:
999:
996:
993:
990:
986:
985:
982:
979:
976:
972:
971:
968:
965:
962:
958:
957:
954:
951:
948:
944:
943:
940:
937:
934:
930:
929:
921:
920:
917:
914:
911:
907:
906:
903:
900:
897:
893:
892:
889:
886:
883:
879:
878:
875:
872:
869:
865:
864:
861:
858:
855:
851:
850:
847:
844:
841:
837:
836:
827:
818:
811:
797:
794:
783:hysterectomies
779:Liam Donaldson
769:
766:
717:
714:
702:corticosteroid
697:
694:
693:
692:
677:
662:
658:thermal energy
651:
629:medical device
620:
609:
593:radiofrequency
586:
566:Electrocautery
562:
523:
520:
512:blood clotting
488:electrocautery
447:
444:
412:immunoglobulin
399:
396:
380:cardiac arrest
327:
324:
320:abnormal voice
303:
300:
278:
275:
248:
245:
204:
201:
177:electrocautery
112:in which both
101:
100:
93:
90:
89:
82:
76:
75:
68:
62:
61:
52:
46:
45:
42:
38:
37:
34:
26:
25:
15:
13:
10:
9:
6:
4:
3:
2:
4888:
4877:
4874:
4872:
4871:Sleep surgery
4869:
4867:
4864:
4862:
4859:
4858:
4856:
4837:
4834:
4833:
4830:
4824:
4821:
4819:
4816:
4815:
4813:
4810:
4808:
4802:
4796:
4795:Adenoidectomy
4793:
4791:
4790:Tonsillectomy
4788:
4787:
4785:
4782:
4780:
4774:
4768:
4765:
4763:
4760:
4759:
4757:
4754:
4752:
4746:
4743:
4741:
4737:
4727:
4726:
4721:
4720:
4718:
4715:
4713:
4707:
4701:
4700:
4695:
4694:
4692:
4689:
4687:
4681:
4675:
4672:
4670:
4667:
4665:
4662:
4661:
4659:
4656:
4654:
4648:
4642:
4639:
4637:
4634:
4632:
4629:
4627:
4624:
4623:
4621:
4618:
4616:
4610:
4607:
4605:
4601:
4597:
4593:
4589:
4582:
4577:
4575:
4570:
4568:
4563:
4562:
4559:
4551:
4547:
4543:
4541:
4538:
4536:
4532:
4529:
4526:
4525:
4521:
4512:
4508:
4504:
4500:
4496:
4492:
4488:
4484:
4480:
4476:
4472:
4465:
4462:
4449:
4445:
4439:
4436:
4421:
4415:
4412:
4407:
4403:
4399:
4395:
4391:
4387:
4382:
4377:
4373:
4369:
4365:
4358:
4355:
4350:
4344:
4340:
4339:
4332:
4330:
4328:
4326:
4324:
4320:
4308:. 28 May 2001
4307:
4303:
4297:
4295:
4291:
4286:
4282:
4277:
4272:
4268:
4264:
4260:
4256:
4252:
4245:
4243:
4241:
4239:
4237:
4235:
4231:
4226:
4222:
4217:
4212:
4208:
4204:
4200:
4193:
4191:
4189:
4187:
4185:
4183:
4181:
4177:
4165:
4161:
4157:
4153:
4147:
4144:
4139:
4135:
4132:(4): 289–96.
4131:
4127:
4119:
4116:
4111:
4107:
4102:
4097:
4093:
4089:
4082:
4079:
4074:
4070:
4066:
4062:
4059:(5): 562–80.
4058:
4054:
4047:
4044:
4039:
4035:
4030:
4025:
4021:
4017:
4013:
4009:
4005:
3998:
3996:
3994:
3992:
3990:
3988:
3984:
3979:
3975:
3971:
3967:
3962:
3957:
3953:
3949:
3945:
3938:
3935:
3923:
3919:
3913:
3910:
3905:
3901:
3897:
3893:
3889:
3885:
3881:
3874:
3871:
3866:
3862:
3857:
3852:
3848:
3844:
3840:
3836:
3832:
3825:
3822:
3817:
3813:
3809:
3805:
3801:
3797:
3793:
3789:
3782:
3779:
3774:
3770:
3765:
3760:
3756:
3752:
3748:
3744:
3740:
3736:
3732:
3725:
3722:
3717:
3713:
3709:
3705:
3698:
3695:
3690:
3684:
3680:
3679:
3671:
3668:
3663:
3657:
3653:
3649:
3648:
3640:
3637:
3632:
3626:
3622:
3621:Pediatric ENT
3615:
3612:
3607:
3603:
3598:
3593:
3589:
3585:
3581:
3577:
3573:
3569:
3565:
3558:
3556:
3552:
3547:
3543:
3538:
3533:
3529:
3525:
3521:
3517:
3513:
3506:
3504:
3500:
3484:
3477:
3471:
3468:
3462:
3457:
3453:
3449:
3445:
3438:
3435:
3422:
3418:
3414:
3408:
3405:
3400:
3396:
3392:
3388:
3384:
3380:
3376:
3372:
3365:
3362:
3357:
3353:
3348:
3343:
3339:
3335:
3332:(6): 807–16.
3331:
3327:
3323:
3316:
3313:
3308:
3304:
3300:
3296:
3292:
3288:
3285:(2): 579–83.
3284:
3280:
3273:
3270:
3265:
3261:
3257:
3253:
3249:
3245:
3241:
3237:
3230:
3227:
3222:
3218:
3213:
3208:
3204:
3200:
3196:
3189:
3186:
3181:
3177:
3172:
3167:
3163:
3159:
3155:
3151:
3147:
3140:
3137:
3132:
3128:
3124:
3120:
3116:
3112:
3109:(5): 337–48.
3108:
3104:
3097:
3094:
3089:
3085:
3081:
3077:
3073:
3069:
3065:
3061:
3054:
3051:
3039:
3035:
3029:
3026:
3021:
3017:
3012:
3007:
3003:
2999:
2995:
2991:
2987:
2983:
2979:
2972:
2970:
2966:
2961:
2957:
2952:
2947:
2943:
2939:
2935:
2928:
2925:
2920:
2916:
2911:
2906:
2902:
2898:
2893:
2888:
2884:
2880:
2876:
2869:
2866:
2861:
2857:
2852:
2847:
2843:
2839:
2834:
2829:
2825:
2821:
2817:
2810:
2807:
2802:
2798:
2794:
2790:
2786:
2782:
2778:
2774:
2767:
2764:
2759:
2755:
2750:
2745:
2740:
2735:
2731:
2727:
2726:BMC Neurology
2723:
2716:
2713:
2708:
2704:
2699:
2694:
2690:
2686:
2682:
2678:
2674:
2670:
2666:
2659:
2657:
2653:
2648:
2644:
2640:
2636:
2632:
2628:
2624:
2620:
2616:
2612:
2608:
2604:
2597:
2594:
2589:
2585:
2581:
2577:
2573:
2569:
2562:
2559:
2554:
2550:
2545:
2540:
2535:
2530:
2526:
2522:
2518:
2511:
2508:
2503:
2499:
2494:
2489:
2485:
2481:
2477:
2473:
2469:
2462:
2460:
2456:
2451:
2447:
2443:
2439:
2435:
2431:
2427:
2423:
2416:
2413:
2408:
2404:
2400:
2396:
2392:
2388:
2381:
2378:
2373:
2369:
2365:
2361:
2357:
2353:
2349:
2345:
2341:
2337:
2330:
2327:
2322:
2318:
2314:
2310:
2306:
2302:
2298:
2294:
2290:
2286:
2282:
2275:
2272:
2259:
2255:
2254:"Tonsillitis"
2249:
2246:
2241:
2237:
2232:
2227:
2223:
2219:
2215:
2211:
2207:
2200:
2198:
2196:
2194:
2192:
2190:
2186:
2181:
2177:
2173:
2169:
2165:
2164:NIHR Evidence
2161:
2155:
2152:
2147:
2143:
2139:
2135:
2130:
2125:
2120:
2115:
2111:
2107:
2103:
2096:
2093:
2088:
2084:
2080:
2076:
2071:
2066:
2062:
2058:
2054:
2047:
2044:
2039:
2035:
2031:
2027:
2023:
2019:
2015:
2011:
2007:
2003:
1999:
1992:
1989:
1984:
1980:
1976:
1972:
1968:
1964:
1960:
1956:
1952:
1948:
1944:
1937:
1934:
1929:
1925:
1921:
1917:
1912:
1907:
1903:
1899:
1895:
1888:
1886:
1884:
1882:
1880:
1876:
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1860:
1854:
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1850:
1848:
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1842:
1837:
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1813:
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1790:
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1771:(4): 307–13.
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1222:
1221:status symbol
1218:
1214:
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826:tonsillectomy
819:
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706:dexamethasone
703:
695:
690:
685:
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680:Microdebrider
678:
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663:
659:
655:
652:
649:
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617:
616:blood vessels
613:
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575:cauterization
573:loss through
572:
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440:breast cancer
437:
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421:
420:meta-analysis
417:
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409:
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398:Immune system
397:
395:
393:
387:
383:
381:
377:
373:
369:
365:
361:
357:
353:
349:
345:
341:
337:
333:
332:complications
326:Complications
325:
323:
322:in children.
321:
317:
313:
309:
308:tonsil stones
301:
299:
297:
293:
289:
284:
276:
274:
272:
265:
260:
258:
255:In 2019, the
253:
246:
244:
242:
238:
234:
233:tonsil cancer
230:
226:
222:
218:
214:
210:
202:
200:
197:
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184:
182:
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174:
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161:
159:
154:
150:
146:
142:
137:
135:
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127:
123:
119:
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111:
107:
106:Tonsillectomy
97:
87:
83:
81:
77:
73:
69:
67:
63:
60:
56:
53:
51:
47:
43:
39:
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24:Tonsillectomy
22:
19:
4805:
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4762:Palatoplasty
4749:
4723:
4710:
4697:
4684:
4651:
4641:Cheiloplasty
4613:
4549:
4478:
4474:
4464:
4452:. Retrieved
4447:
4438:
4426:. Retrieved
4414:
4371:
4367:
4357:
4337:
4310:. Retrieved
4305:
4258:
4254:
4209:(1): 59–63.
4206:
4202:
4167:. Retrieved
4155:
4146:
4129:
4125:
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4091:
4081:
4056:
4052:
4046:
4011:
4007:
3954:(5): 680–4.
3951:
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3937:
3925:. Retrieved
3921:
3912:
3879:
3873:
3838:
3834:
3824:
3794:(2): 281–6.
3791:
3787:
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3574:: CD005607.
3571:
3567:
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3490:. Retrieved
3483:the original
3470:
3451:
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3437:
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3421:the original
3416:
3407:
3374:
3370:
3364:
3329:
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3278:
3272:
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3066:(5): 882–7.
3063:
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3037:
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2941:
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2675:(2): 90–99.
2672:
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2262:. Retrieved
2257:
2248:
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2163:
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2005:
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1953:(S1): S1-8.
1950:
1946:
1936:
1904:(2): 111–7.
1901:
1897:
1866:. Retrieved
1863:ec.europa.eu
1862:
1811:
1808:Medical Care
1807:
1801:
1768:
1764:
1758:
1715:
1711:
1655:
1651:
1645:
1620:
1616:
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1500:
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1197:tonsillotome
1182:
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719:
699:
679:
664:
653:
622:
611:
591:: Monopolar
588:
564:
538:
525:
516:
480:tonsillotomy
479:
473:
401:
388:
384:
372:laryngospasm
329:
305:
280:
267:
262:
254:
250:
206:
203:Medical uses
185:
162:
138:
105:
104:
18:
4674:Glossectomy
3710:: 469–472.
3492:30 November
3156:(2): 90–3.
2603:Ben-Horin S
2129:10023/27774
1176:(1672) and
1134:Middle Ages
1105:(25 BCE–50
1101:aristocrat
747:paracetamol
723:dehydration
696:Medications
648:coagulation
606:tonsillitis
549:to undergo
340:dehydration
292:sleep study
247:Sore throat
213:tonsillitis
209:sleep apnea
169:paracetamol
153:Throat pain
149:dehydration
122:tonsillitis
80:MedlinePlus
41:Other names
4855:Categories
4740:Oropharynx
4588:Procedures
4481:: 111290.
4450:(in Dutch)
4368:The Lancet
3927:27 January
2826:: 925596.
2527:(1): 242.
2210:Pediatrics
2106:The Lancet
1237:References
1170:hoarseness
1162:secretions
1156:, and the
1146:Peter Lowe
1071:remarked:
824:undergoing
673:outpatient
669:gag reflex
633:ultrasonic
428:odds ratio
426:, with an
408:infections
364:aspiration
312:bad breath
4818:Uvulotomy
4511:251706895
4495:0165-5876
4390:0140-6736
4312:2 October
4255:Med. Hist
4169:5 January
4164:0362-4331
3896:1469-493X
3755:1469-493X
3588:1469-493X
3264:206199958
3002:1469-493X
2901:1559-0755
2842:2234-943X
2801:219775558
2793:0732-183X
2689:1918-2805
2647:244686665
2631:1365-2036
2372:220943451
2356:0003-4894
2305:1531-4995
2180:261565310
2138:0140-6736
2079:1424-3997
2022:0003-4894
1967:0194-5998
1868:8 October
1732:1865-1011
1718:: Doc07.
1672:1749-4486
1623:: 41–50.
1111:procedure
1037:1,630,807
743:ibuprofen
636:vibrating
492:diathermy
418:. A 2024
318:, and an
223:(PFAPA),
196:inpatient
165:ibuprofen
4631:Lip lift
4531:Archived
4503:36067711
4398:25072064
4285:29553012
4225:20476427
4110:21304842
4073:19399752
4038:30397014
3978:33142532
3970:20974339
3904:24022333
3865:23881651
3808:15692542
3773:10796831
3606:23235625
3597:11366083
3546:21833946
3391:14603065
3356:21373898
3307:30491811
3299:21547390
3256:22833366
3221:23248656
3180:23799166
3123:17431570
3088:41047058
3080:12792327
3020:21412878
2960:22431869
2919:34523058
2860:35936707
2758:23648120
2707:38716286
2698:11073456
2639:34820868
2588:26436644
2553:35751056
2502:28094660
2442:24691645
2407:28927847
2364:32741219
2321:73503702
2313:30848478
2240:28096515
2146:37209706
2087:17705110
2038:46503189
2030:12450171
1975:18164373
1928:31719394
1920:20500580
1836:22239630
1828:23969585
1793:42461145
1785:25658777
1750:25587367
1680:27506317
1637:29224763
1602:27591015
1572:BMJ Open
1550:26055199
1485:26465274
1423:25407135
1350:30798778
1158:excision
1154:ligature
1142:ligature
1003: 1
989: 2
601:scarring
559:bleeding
508:thrombin
344:ear pain
283:Cochrane
227:, nasal
145:vomiting
141:bleeding
50:ICD-9-CM
4712:gingiva
4596:pharynx
4428:20 June
4406:5161486
4276:5883156
4216:2384338
4138:5451974
4101:2378727
4029:6301361
3856:7154573
3816:3189359
3764:7025437
3537:6485432
3427:11 July
3399:7386342
3347:3087106
3212:3523437
3171:3687068
3131:7088360
3043:15 July
3011:7097733
2910:8580919
2851:9350012
2749:3651719
2544:9229076
2493:5639328
2264:22 June
2231:5260157
1741:4273168
1688:1784671
1593:5020755
1476:9242010
1414:7075105
1081:History
1020:701,266
1006:446,275
992:251,247
950:170,687
754:codeine
627:: This
555:patient
547:patient
528:scalpel
522:Methods
504:sutures
484:scalpel
181:adenoid
72:D014068
4866:Tonsil
4779:tonsil
4751:palate
4653:tongue
4509:
4501:
4493:
4454:7 July
4404:
4396:
4388:
4345:
4283:
4273:
4223:
4213:
4162:
4136:
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3658:
3627:
3604:
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3586:
3544:
3534:
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3354:
3344:
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3219:
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3121:
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3078:
3018:
3008:
3000:
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2917:
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2858:
2848:
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2799:
2791:
2756:
2746:
2732:: 41.
2705:
2695:
2687:
2645:
2637:
2629:
2586:
2551:
2541:
2500:
2490:
2450:370599
2448:
2440:
2405:
2370:
2362:
2354:
2319:
2311:
2303:
2258:nhs.uk
2238:
2228:
2178:
2144:
2136:
2085:
2077:
2036:
2028:
2020:
1983:704501
1981:
1973:
1965:
1926:
1918:
1834:
1826:
1791:
1783:
1748:
1738:
1730:
1686:
1678:
1670:
1635:
1600:
1590:
1548:
1508:
1483:
1473:
1421:
1411:
1348:
1174:Dionis
1166:larynx
1152:, the
1123:Aetius
1047:100.0%
998:14.3%
956:30.1%
942:12.4%
936:25,420
905:12.3%
899:15,205
877:11.6%
871:15,320
751:opioid
727:circle
583:tissue
500:lasers
476:fascia
356:larynx
188:Celsus
179:. The
118:throat
86:003013
4807:uvula
4686:teeth
4604:Mouth
4592:mouth
4507:S2CID
4423:(PDF)
4402:S2CID
3974:S2CID
3812:S2CID
3486:(PDF)
3479:(PDF)
3395:S2CID
3303:S2CID
3260:S2CID
3127:S2CID
3084:S2CID
2797:S2CID
2643:S2CID
2446:S2CID
2368:S2CID
2317:S2CID
2176:S2CID
2034:S2CID
1979:S2CID
1924:S2CID
1832:S2CID
1789:S2CID
1684:S2CID
1451:(PDF)
1389:(PDF)
1193:uvula
1150:snare
1119:snare
1115:Galen
1099:Roman
1032:Total
1026:4.7%
1012:9.9%
984:0.0%
970:0.2%
919:0.5%
916:14.8%
902:14.8%
891:3.9%
888:22.2%
885:3,185
874:13.9%
863:0.1%
849:0.0%
768:Rates
735:scabs
704:drug
684:sinus
631:uses
571:blood
490:, or
352:teeth
302:Other
108:is a
94:[
4722:see
4696:see
4594:and
4499:PMID
4491:ISSN
4456:2019
4430:2019
4394:PMID
4386:ISSN
4343:ISBN
4314:2019
4281:PMID
4221:PMID
4171:2019
4160:ISSN
4134:PMID
4106:PMID
4069:PMID
4034:PMID
3966:PMID
3929:2018
3900:PMID
3892:ISSN
3861:PMID
3839:2013
3804:PMID
3769:PMID
3751:ISSN
3739:1999
3708:1254
3683:ISBN
3656:ISBN
3625:ISBN
3602:PMID
3584:ISSN
3542:PMID
3520:2011
3494:2013
3429:2016
3387:PMID
3352:PMID
3295:PMID
3252:PMID
3217:PMID
3176:PMID
3119:PMID
3076:PMID
3045:2016
3016:PMID
2998:ISSN
2986:2011
2956:PMID
2915:PMID
2897:ISSN
2856:PMID
2838:ISSN
2789:ISSN
2754:PMID
2703:PMID
2685:ISSN
2635:PMID
2627:ISSN
2584:PMID
2549:PMID
2498:PMID
2438:PMID
2403:PMID
2360:PMID
2352:ISSN
2309:PMID
2301:ISSN
2266:2019
2236:PMID
2142:PMID
2134:ISSN
2083:PMID
2075:ISSN
2026:PMID
2018:ISSN
1971:PMID
1963:ISSN
1916:PMID
1870:2019
1824:PMID
1781:PMID
1746:PMID
1728:ISSN
1676:PMID
1668:ISSN
1633:PMID
1598:PMID
1546:PMID
1506:ISBN
1481:PMID
1459:2015
1419:PMID
1397:2014
1346:PMID
1132:The
1042:1.1%
1023:0.1%
1009:0.4%
981:4.7%
967:3.7%
953:3.2%
939:8.9%
860:3.4%
745:and
526:The
378:and
358:and
288:AHRQ
235:and
167:and
128:and
66:MeSH
59:28.3
55:28.2
4615:lip
4483:doi
4479:162
4376:doi
4372:384
4271:PMC
4263:doi
4211:PMC
4096:PMC
4061:doi
4024:PMC
4016:doi
3956:doi
3952:143
3884:doi
3851:PMC
3843:doi
3796:doi
3792:132
3759:PMC
3743:doi
3712:doi
3652:357
3592:PMC
3576:doi
3532:PMC
3524:doi
3456:doi
3452:108
3379:doi
3375:113
3342:PMC
3334:doi
3330:268
3287:doi
3283:269
3244:doi
3240:122
3207:PMC
3166:PMC
3158:doi
3111:doi
3103:Hno
3068:doi
3064:113
3006:PMC
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