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Ear, nose and throat/otolaryngology
Research
Trends and changes in paediatric tonsil surgery in Sweden 1987–2013: a population-based cohort study
  1. Anna Borgström1,2,
  2. Pia Nerfeldt1,2,
  3. Danielle Friberg1,2,
  4. Ola Sunnergren3,
  5. Joacim Stalfors4
  1. 1Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
  2. 2Department of Clinical Science, Intervention and Technology, CLINTEC, Karolinska Institute, Stockholm Sweden
  3. 3Department of Otorhinolaryngology, Ryhov County Hospital, Jönköping, Sweden
  4. 4Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
  1. Correspondence to Dr Anna Borgström; anna.borgstrom{at}karolinska.se

Abstract

Objectives The objective of this study was to longitudinally describe the history of tonsil surgery in Swedish children and adolescents regarding incidence, indications for surgery, surgical methods and the age and gender distributions.

Setting A retrospective longitudinal population-based cohort study based on register data from the Swedish National Patient Register (NPR) and population data from Statistics Sweden.

Participants All Swedish children 1–<18 years registered in the NPR with a tonsil surgery procedure 1987–2013.

Results 167 894 tonsil surgeries were registered in the NPR 1987–2013. An increase in the total incidence rate was observed, from 22/10 000 person years in 1987 to 47/10 000 in 2013. The most marked increase was noted in children 1–3 years of age, increasing from 17 to 73/10 000 person years over the period. The proportion children with obstructive/sleep disordered breathing (SDB) indications increased from 42.4% in 1987 to 73.6% in 2013. Partial tonsillectomy, tonsillotomy (TT), increased since 1996 and in 2013 55.1% of all tonsil procedures were TTs.

Conclusions There have been considerable changes in clinical practice for tonsil surgery in Swedish children over the past few decades. Overall, a doubling in the total incidence rate was observed. This increase consisted mainly of an increase in surgical procedures due to obstructive/SDB indications, particularly among the youngest age group (1–3 years old). TT has gradually replaced tonsillectomy as the predominant method for tonsil surgery.

  • tonsillectomy
  • tonsillotomy
  • tonsil surgery
  • register

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-013346

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    Footnotes

    • Contributors AB and JS contributed to the study design. AB, PN, DF, OS and JS contributed to the interpretation and analysis of data. AB wrote the first draft of the manuscript. PN, DF, OS and JS contributed to the final writing and revising of the manuscript and checked for important intellectual content. All authors approved of the final manuscript as submitted.

    • Funding This study was supported by financial grants from the Acta Otolaryngologica Foundation, the Freemason Child House Foundation in Stockholm and The Health and Medical Care Committee of the Regional Executive Board, Region Västra Götaland.

    • Competing interests None declared.

    • Ethics approval This study was approved by the regional ethical review board of Gothenburg, Sweden (Dnr 534-14).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.