Table 3.
Intervention and comparator | Number/Type of Studies (Total N Participants) | Key Outcome(s) | Strength of Evidence (SOE) Grade | Findings |
---|---|---|---|---|
Total vs. partial cold dissection tonsillectomy | 2 RCT18,22 (131) | Return to normal diet | Low SOE for faster return to normal diet after partial vs. total tonsillectomy | Children undergoing partial tonsillectomy returned to normal diet approximately 4 days sooner than children undergoing total tonsillectomy according to parent report |
1 RCT18 (101) | Throat infection, OSDB persistence | Insufficient SOE | Insufficient data to assess effects on throat infections given single, small study | |
Partial vs. total coblation tonsillectomy | 1 RCT21 (69) | Return to normal diet or activity | Insufficient SOE | Insufficient data to assess effects on return to normal diet or activity given single, small study |
Partial vs. total electrocautery tonsillectomy | 1 RCT23 (40) | Return to normal activity | Insufficient SOE | Insufficient data to assess effects on return to normal diet or activity given single, small study |
Total vs. partial tonsillectomy (mixed techniques) | 6 RCT24,26–28,32,34,35 (620) | Return to normal diet or activity | Low SOE for more favorable return to normal diet and activity in children undergoing partial vs. total tonsillectomy | Children undergoing partial vs. total tonsillectomy had consistently more favorable outcomes but unit of measure varied across studies (e.g., mean days, N children) |
3 RCT26–31 (214) | OSDB persistence | Low SOE for no difference in effects on long-term persistence of OSDB symptoms between partial and total tonsillectomy | More children undergoing partial vs. total tonsillectomy had short-term snoring or obstructive symptoms in 2 studies but no group differences in longer term in any study | |
2 RCT26,27,29–31 (159) | Quality of Life (≥12 months post-tonsillectomy) | Low SOE for no long-term differences in quality of life after partial vs. total tonsillectomy | Improvements from baseline in both groups in 2 small studies, but no significant group differences in quality of life in either study | |
2 RCT26,27,29–31 (159) | Behavioral Outcomes (≥12 months post-tonsillectomy) | Low SOE for no long-term differences in behavioral outcomes after partial vs. total tonsillectomy | Improvements from baseline in both groups on the Child Behavior Checklist in 2 small studies, but no significant group differences in either study | |
4 RCT26–31,33 (296) | Throat Infections (≥12 months post-tonsillectomy) | Low SOE for no effect on throat infections following partial vs. total tonsillectomy | More throat infections or sore throats following partial vs. total tonsillectomy in 3 of 4 RCTs but no significant group differences |
Abbreviations: N=number; OSDB=obstructive sleep disordered breathing; RCT= randomized controlled trial; SOE=strength of evidence