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Long-Term Efficacy and Cost-Effectiveness of Laser Tonsillotomy vs Tonsillectomy: A Secondary Analysis of a Randomized Clinical Trial

Importance of the Study

The traditional treatment for tonsil issues in adults, called tonsillectomy (TE), often requires a long and difficult recovery period.

Objective of the Study

This study aimed to compare the long-term effectiveness and cost of a new treatment called carbon dioxide (CO2) laser tonsillotomy (TO) with the standard tonsillectomy.

Study Overview

The analysis involved data from a clinical trial conducted in five hospitals in the Netherlands, including adults suffering from ongoing tonsil-related symptoms.

Methods Used

Participants underwent either a tonsillectomy under general anesthesia or a CO2 laser tonsillotomy under local anesthesia. The study measured various outcomes one and two years after treatment.

Main Findings

Out of 199 patients, those who had CO2 laser tonsillotomy experienced persistent symptoms more often than those who had tonsillectomy:

  • 1 year: 51.8% for TO vs 25.2% for TE
  • 2 years: 45.2% for TO vs 19.7% for TE

Symptom severity improved in both groups, but was better after tonsillectomy:

  • 1 year: 14.8 mm for TE vs 23.0 mm for TO
  • 2 years: 10.8 mm for TE vs 19.6 mm for TO

Patient satisfaction was similar for both treatments, with a slight preference for tonsillectomy.

Cost-Effectiveness

CO2 laser tonsillotomy was significantly cheaper, costing about $869 compared to $2363 for tonsillectomy, resulting in a cost saving of $1925.

Conclusions

Both treatments effectively reduced symptoms, but tonsillectomy provided better long-term results. CO2 laser tonsillotomy is a more affordable option with similar patient satisfaction.

Recommendations

For clinics and patients, consider CO2 laser tonsillotomy for its cost-effectiveness and satisfactory outcomes. Monitor results and patient experiences closely to ensure the best care.

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