Global tonsillectomy practice patterns – A survey study of pediatric otolaryngologists
Bibliographic record
Abstract
OBJECTIVE: There is variation in surgical techniques and postoperative management of tonsillectomy globally. Our objective was to consolidate international similarities and differences in tonsillectomy management by pediatric otolaryngologists. METHODS: This cross-sectional survey study was conducted from April 4 to May 16, 2024. It involved a 55-item questionnaire distributed online to an international sample of pediatric otolaryngologists via an international WhatsApp group comprising pediatric otolaryngologists from various countries. The study achieved responses from 132 out of 293 invited pediatric otolaryngologists (45.1 % response rate). Participants were from 22 countries. Eligibility included proficiency in English and currently practicing pediatric otolaryngology. RESULTS: Among respondents, the majority primarily performed extracapsular tonsillectomy (44.7 %), followed by those who used both intracapsular and extracapsular tonsillectomy equally (34.8 %), and those who predominantly performed intracapsular tonsillectomy (20.5 %). Ideal patient candidates for extracapsular tonsillectomy included those with recurrent tonsillitis (70.5 %), recurrent peritonsillar abscesses (67.4 %), and obstructive sleep apnea (46.2 %). Ideal candidates for intracapsular tonsillectomy were those with obstructive sleep apnea (50.0 %) and bleeding disorders (38.6 %). Intracapsular tonsillectomy adoption was notably high in this cohort, with 68.8 % of European respondents favoring intracapsular tonsillectomy. Postoperative pain management varied, with 76.5 % of respondents using acetaminophen, 77.3 % using ibuprofen, and 28.8 % prescribing opioids, primarily oxycodone (48.6 %). Access to polysomnography was reported by 84.0 % of respondents. Common indications for inpatient admission included age under three (75.8 %), medical comorbidity (71.2 %), and severe sleep apnea (59.1 %). CONCLUSION: This study highlights the increasing adoption of intracapsular tonsillectomy and the need for comprehensive guidelines addressing the observed global variability in practices.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".