{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:40:31Z","timestamp":1787841631256,"version":"build-2784847793"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether the decline in tonsillectomy and adenoidectomy during the COVID\u201019 pandemic in Japan was age\u2010dependent and to examine trends in postoperative hemostasis activity using nationwide claims data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide longitudinal descriptive study using National Database Open Data from fiscal years (FY) 2015\u20132023. Annual procedure counts were extracted for tonsillectomy (K377\u20101), adenoidectomy (K370), and postoperative hemostasis after tonsil surgery (K367\u2010a). Pandemic phases were defined as pre\u2010COVID (FY2015\u2013FY2019), COVID onset (FY2020), COVID ongoing (FY2021\u2013FY2022), and recovery (FY2023). Age\u2010stratified analyses were performed for tonsillectomy. The postoperative hemostasis rate was calculated per 1000 tonsillectomies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Tonsillectomy and adenoidectomy volumes increased through FY2019, reaching 73,577 and 14,910 cases, respectively, before declining sharply in FY2020 to 47,097 and 7018. The reduction in tonsillectomy was strongly age\u2010dependent and greatest among children aged 0\u201314\u2009years, with a 48.9% decrease from FY2019 to FY2020 (29,340\u201314,992), whereas the decline among adults aged \u2265\u200960\u2009years was smaller at 12.5% (5433\u20134752). Surgical volumes remained suppressed during FY2021\u2013FY2022 and partially recovered in FY2023 but did not return to prepandemic peak levels. The absolute number of postoperative hemostasis procedures remained relatively stable over time; however, the hemostasis rate increased during the pandemic period because tonsillectomy volume declined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The pandemic\u2010associated reduction in tonsillectomy and adenoidectomy in Japan was disproportionately concentrated in pediatric patients. Despite reduced surgical volume, the absolute postoperative hemostasis activity was relatively preserved. These findings provide nationwide evidence of age\u2010dependent disruption in elective otolaryngologic procedures during the COVID\u201019 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>4.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70489","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:30:00Z","timestamp":1782916200000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age\u2010Dependent Decline in Tonsillectomy and Adenoidectomy During the\n                    <scp>COVID<\/scp>\n                    \u201019 Pandemic in Japan: A Nationwide Longitudinal Analysis of\n                    <scp>NDB<\/scp>\n                    Open Data"],"prefix":"10.1002","volume":"11","author":[{"given":"Nayu","family":"Yokoyama","sequence":"first","affiliation":[{"name":"Department of Otolaryngology St. Marianna University School of Medicine  Kawasaki Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masao","family":"Noda","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery Jichi Medical University  Shimotsuke Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masamitsu","family":"Kono","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakazu","family":"Hamamoto","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Kawasaki Medical School  Kurashiki Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Shimada","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery Jichi Medical University  Shimotsuke Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Kawasaki Medical School  Kurashiki Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery Jichi Medical University  Shimotsuke Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manabu","family":"Komori","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology St. Marianna University School of Medicine  Kawasaki Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2022.08.008"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.70274"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010020\u201006161\u2010x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004528"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znab028"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2024.03.002"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.6173"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010021\u201006461\u20105"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/v14071417"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms10101947"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.37737\/ace.23008"},{"key":"e_1_2_10_13_1","volume-title":"National 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