A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä

Tonsillotomy for Periodic Fever Syndrome: A Randomized and Controlled Trial




TekijätLantto Ulla, Tapiainen Terhi, Pokka Tytti, Koivunen Petri, Helminen Merja, Piitulainen Jaakko, Rekola Jami, Uhari Matti, Renko Marjo

KustantajaWILEY

Julkaisuvuosi2023

JournalLaryngoscope

Tietokannassa oleva lehden nimiLARYNGOSCOPE

Lehden akronyymiLARYNGOSCOPE

Vuosikerta134

Numero2

Aloitussivu968

Lopetussivu972

Sivujen määrä5

ISSN0023-852X

eISSN1531-4995

DOIhttps://doi.org/10.1002/lary.30863

Verkko-osoitehttps://doi.org/10.1002/lary.30863

Rinnakkaistallenteen osoitehttps://research.utu.fi/converis/portal/detail/Publication/180336676


Tiivistelmä

Objective: Tonsillectomy is an effective treatment for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome. Tonsillotomy has a milder operative risk profile and postoperative morbidity in children than tonsillectomy. We aimed to compare the efficacy of tonsillotomy to observation-only in children with PFAPA syndrome at a 3-month follow-up.

Methods: This was a randomized multicenter trial with sequential design. Participants were randomized into a tonsillotomy group and a control group that was only observed. The trial started in 1/2017 and was accomplished in 12/2021 with 16 patients (10 boys, six girls, the mean age 4.2 years). The symptoms were monitored with daily symptom diaries.

Results: After the 3-month follow-up, 7/8 patients (87.5%) in the tonsillotomy group and 2/8 (25%) patients in the control group were free from PFAPA symptoms (95% CI 13% to 87%; p = 0.0021). The mean number of days with fever was 2.6 (SD 3.7) in the tonsillotomy group and 8.0 (SD 6.5) days in the control group (n = 8) (p = 0.06). Mean number of fever days compatible with PFAPA syndrome was 0.8 (SD 1.4) in the tonsillotomy group and 6.5 (SD 6.0) in the control group (95%CI -10% to -1%; p = 0.007). Rescue tonsillectomy was needed for all patients in the control group and none of the patients in the tonsillotomy group.

Conclusions: Tonsillotomy might be an effective treatment option for children with PFAPA syndrome. Further studies are needed to clarify the long-term efficacy of tonsillotomy for treating PFAPA.


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Last updated on 2025-13-02 at 16:07