{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T19:07:50Z","timestamp":1757617670837,"version":"3.44.0"},"reference-count":12,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009752","name":"Futurum - Akademin f\u00f6r H\u00e4lsa och V\u00e5rd, Region J\u00f6nk\u00f6pings l\u00e4ns","doi-asserted-by":"publisher","award":["1015098"],"award-info":[{"award-number":["1015098"]}],"id":[{"id":"10.13039\/501100009752","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007363","name":"Stiftelsen Acta Oto-Laryngologica","doi-asserted-by":"publisher","award":["1 month (no grant\/award number)"],"award-info":[{"award-number":["1 month (no grant\/award number)"]}],"id":[{"id":"10.13039\/501100007363","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the safety and clinical outcomes (bleeding rate, requirement for revision surgery, and patient\u2010reported symptom relief) of pediatric cold steel tonsillotomy with or without adenoidectomy (TT\/TTA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients aged \u2264\u200918\u2009years who underwent cold steel TT\/TTA for the management of upper airway obstruction in Region J\u00f6nk\u00f6ping County, Sweden, between October 1, 2013, and September 31, 2023, were included in this single center, retrospective, cohort study. Data regarding postoperative bleeding and revision surgery were extracted from electronic medical records. Patient\u2010reported outcomes were obtained from the Swedish Quality Register of Tonsil Surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 1810 cold steel TT\/TTA procedures included in the analysis, 36 (2.0%) bleeding events were identified, comprising 12 (0.7%) and 24 (1.3%) cases involving tonsils and adenoid beds, respectively. Four (0.2%) and seven (0.4%) patients with tonsil and adenoid bleeding, respectively, required surgical intervention. No significant risk factors for postoperative bleeding were identified. The rate of revision surgery owing to regrowth of tonsil tissue or recurrent infections was 5.1%. Younger age at the time of the first surgery was a significant risk factor for revision surgery (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Complete (64.9%) or almost complete (29.5%) resolution of symptoms was reported in 94.4% (<jats:italic>n<\/jats:italic>\u2009=\u2009868) of the patients 6 months postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cold steel TT\/TTA is a safe and efficient surgical procedure for pediatric patients with upper airway obstruction owing to tonsil and adenoid hypertrophy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence: 4.<\/jats:title><\/jats:sec>","DOI":"10.1002\/lary.32174","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T03:13:18Z","timestamp":1744081998000},"page":"2935-2941","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative Bleeding, Revision Surgery, and Outcome of Cold Steel Tonsillotomy in Children With Upper Airway Obstruction"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5110-9344","authenticated-orcid":false,"given":"Hanna","family":"Gerhardsson","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology  J\u00f6nk\u00f6ping Sweden"},{"name":"Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joacim","family":"Stalfors","sequence":"additional","affiliation":[{"name":"Region V\u00e4stra G\u00f6taland S\u00f6dra \u00c4lvsborgs Hospital  Bor\u00e5s Sweden"},{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ola","family":"Sunnergren","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology  J\u00f6nk\u00f6ping Sweden"},{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Region V\u00e4stra G\u00f6taland Sahlgrenska University Hospital, Department of Otorhinolaryngology\u2014Head and Neck Surgery  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010013\u20102374\u20107"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2020.1746396"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820917394"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22347"},{"issue":"4","key":"e_1_2_8_6_1","first-page":"38","article-title":"Tonsillotomi med kallt st\u00e5l\u2014S\u00e4kert, effektivt och billigt","volume":"22","author":"Sundh C.","year":"2015","journal-title":"Svensk \u00d6NH\u2010Tidskrift"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27665"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13790"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13929"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2022.111132"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010015\u20103871\u20107"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010017\u20104543\u20106"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2024.111942"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.32174","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T07:41:44Z","timestamp":1757144504000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.32174"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,8]]},"references-count":12,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/lary.32174"],"URL":"https:\/\/doi.org\/10.1002\/lary.32174","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"type":"print","value":"0023-852X"},{"type":"electronic","value":"1531-4995"}],"subject":[],"published":{"date-parts":[[2025,4,8]]},"assertion":[{"value":"2024-12-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}