ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2025
Barbed tonsillectomy.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeAlthough tonsillectomy is a common otolaryngological procedure renowned for its ease and safety, it is associated with various complications such as hemorrhage, dysphagia, pain, and infection. Post-tonsillectomy bleeding, especially secondary bleeding, poses a significant risk, with mortality rates reported as 5% of cases. Various techniques have been proposed to mitigate these risks, including the closure of the tonsillar fossa to prevent hemorrhage. Suturing of tonsil pillars has been suggested to enhance healing by reducing exposed surfaces. However, complications such as arterial injury and infection have been reported. This study aimed to investigate the efficacy of barbed sutures for reducing post-tonsillectomy complications compared to standard techniques.
methodsThis prospective case-control study included 25 patients to receive a tonsillectomy with silk sutures (n = 11) or a tonsillectomy with barbed sutures (n = 14). Patients underwent either Barbed Tonsillectomy (BT) or standard tonsillectomy with external silk sutures. Pain scores were assessed using a visual analogue scale (VAS), while oropharyngeal dysphagia was evaluated using the Eating Assessment Tool (EAT-10) at two weeks and one month post-operation.
resultsBT showed significantly lower postoperative pain scores than standard tonsillectomy at 24 hours (VAS: 2.9 vs. 7.0) and after two weeks (VAS: 0.1 vs. 3.4). Similarly, BT demonstrated lower EAT-10 scores at two weeks (0.6 vs. 8.2) and one month (0.9 vs. 5.3), thus indicating reduced dysphagia. Only one patient in the control group required surgical revision due to bleeding, and none in the BT group. Comparison of all variables showed always a statistically significant (p<0.05).
conclusionsThis study showed that barbed sutures in tonsillectomy may be a safe technique with reduced complications and a faster recovery. Initial findings regarding hemorrhage, pain management, and recovery outcomes are highly promising, warranting further investigation with larger sample sizes to endorse these results.
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