Dutch Trial Does Not Appear to Sway View on Tonsil Surgery
In another study, tonsillectomy reduces nasalance and shimmer in some patients' voices
FRIDAY, Oct. 23 (HealthDay News) -- A 2004 trial finding equal benefits from adenotonsillectomy and watchful waiting in children moderately affected by throat infections or adenotonsillar enlargement had little effect on Dutch doctors' beliefs regarding the surgery, and tonsillectomy can treat vocal nasalance, according to two studies in the October Archives of Otolaryngology -- Head & Neck Surgery.
Maroeska M. Rovers, Ph.D., of the University Medical Center Utrecht in the Netherlands, and colleagues analyzed data from surveys sent to 120 otolaryngologists and 120 general practitioners assessing their views on the benefits of adenotonsillectomy before and after the 2004 trial. Most otolaryngologists (94 percent) and some general practitioners (31 percent) knew about the trial. However, their beliefs before and after were similar, and they generally maintained high expectations about the usefulness of the surgery.
Vijayalakshmi Subramaniam and Padmanabhan Kumar of the Yenepoya Medical College in Mangalore, India, analyzed data from 20 children and adults who underwent acoustic analysis before and after tonsillectomy with or without adenoidectomy, along with 46 matched controls. After the surgery, shimmer -- which the authors define as cycle-to-cycle variation in amplitude of successive glottal cycles -- was reduced in some age and gender subgroups, as was nasalance.
"When the correlation between grade of tonsillar hypertrophy and voice parameters was tested, only nasalance showed a significant correlation. A decrease in nasalance scores after surgery was observed in patients with larger tonsils, while an increase was noted in patients with smaller tonsils," Subramaniam and Kumar conclude.