Cover

Recent Advances in Tonsils and Mucosal Barriers of the Upper Airways

7th International Symposium on Tonsils and Mucosal Barriers of the Upper Airways, Asahikawa, July 2010: Proceedings

Editor(s): Harabuchi Y. (Asahikawa) 
Hayashi T. (Asahikawa) 
Katada A. (Asahikawa) 
Table of Contents
Vol. 72, 2011
Section title: Medical and Surgical Treatments of Pharyngotonsillitis
Harabuchi Y (ed): Recent Advances in Tonsils and Mucosal Barriers of the Upper Airways. Adv Otorhinolaryngol. Basel, Karger, 2011, vol 72, pp 142–145
(DOI:10.1159/000324772)

Clinical Guideline on Adenotonsillectomy: The Italian Experience

Bellussi L.M. · Marchisio P. · Materia E. · Passàli F.M.
aENT Clinic University of Siena, Siena, bDepartment of Maternal and Pediatric Sciences, University of Milan Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan, Milan, cPublic Health Agency Lazio-Sanità Roma, Roma, and dENT Department Tor Vergata University Roma, Roma, Italy

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Abstract

Five years after publishing the document on ‘The clinical and organizational appropriateness of tonsillectomy and adenoidectomy’ in 2003, a multidisciplinary group of experts came together again to update this document and to publish a guideline with grading of evidences and recommendations. Major revisions of the previous document were addressed to: (1) the diagnosis and indications for adenotonsillectomy in presence of OSAS in children, (2) the analysis of advantages of new surgical techniques in terms of effectiveness, costs or the risk of postsurgery bleeding and recurrences, and (3) the efficacy of perioperative management in reducing the incidence and duration of post-operative events. In fact, in the last years, a relevant number of evidence became available on the above-mentioned items making the need for a continuing updating of guidelines tangible. As a premise to the guideline, it is stressed how the previous document impact was prominent: the decrease of total number of tonsillectomy in Italy was evident and accompanied by a decrease of variations in the regional rates. Besides the document contributed to strengthen the multidisciplinary collaboration, especially between pediatricians and otorhinolaryngologists, and to divulge the Evidence-Based Medicine culture.



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References

  1. Italian National Programme for Clinical Guidelines (PNLG) Address Document: The clinical and organisational appropriateness of tonsillectomy and/or adenoidectomy. Available athttp://www.pnlg.it
  2. Materia E, Di Domenicantonio R, Baglio G, et al: Epidemiology of tonsillectomy and/or adenoidectomy in Italy. Pediatr Med Chir 2004;26:179-186
  3. Materia E, Rossi L, Di Domenicantonio R, et al: Impatto del documento PNLG sugli interventi di adenotonsillectomia. Rapporto Osservazionale 2007;
  4. Motta G, Casolino D, Cassiano B, et al: Adenotonsillar surgery in Italy. Acta Otorhinolaryngol Ital 2008;28:1-6
  5. National Prospective Tonsillectomy Audit: Final report London: The Royal College of Surgeons of England. 2005;Available atwww.rcseng.ac.uk
  6. Mowatt G, Cook JA, Fraser C, et al: Systematic review of the safety of electro-surgery for tonsillectomy. Clin Otolaryngol 2006;31:95-102
  7. Di Rienzo Businco L, Coen Tirelli G: Paediatric tonsillectomy: radiofrequency based plasma dissection compared to cold dissection with sutures. Acta Oto- rhinolaryngol Ital 2008;28:67-72
  8. Brigger MT, Brietzke SE: Outpatient tonsillectomy in children: a systematic review. Otolaryngol Head Neck Surg 2006;135:1-7
  9. Singarelli S, Berni A, Coppo G, et al: Day surgery one-day surgery: the experience of an ENT unit in a 250 bed hospital. Acta Otorhinolaryngol Ital 2005;25:365-369


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