{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T11:04:51Z","timestamp":1783940691341,"version":"3.55.0"},"reference-count":16,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Entire Medical Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Irreversible electroporation (IRE) is a non-thermal tissue ablation technology, offering potential advantages such as reductions in pain, bleeding, and procedural time. With this study, we aimed to evaluate the safety and efficacy of IRE for the treatment of adenotonsillar hypertrophy in pediatric patients. Methods: In this prospective, two-center, interventional case series, we enrolled 31 children aged 3\u201313 years with adenotonsillar hypertrophy and upper airway obstruction. All procedures were performed under general anesthesia. IRE was applied to the tonsils and adenoids using the ENTire\u2122 system. Postoperative pain was recorded daily for seven days using the Parent\u2019s Postoperative Pain Measure. Disease-specific quality of life was assessed at baseline and three months post-procedure using the Obstructive Sleep Apnea questionnaire (OSA-18). Tonsillar size was graded according to the Brodsky Scale. Results: The mean procedure time was 10:40 \u00b1 03:40, and there was no intraoperative or postoperative bleeding. Patients were discharged on the day of the procedure. The postoperative pain on day 1 was ranked as 3.5 \u00b1 1.5 and resolved completely in all patients by day 7. From baseline to 3 months, the mean OSA-18 decreased from 66.4 \u00b1 14.9 to 24.6 \u00b1 9.9 (Wilcoxon signed-rank test p-value of &lt;0.0001), and the Brodsky grade decreased from 3.26 \u00b1 0.63 to 0.92 \u00b1 0.61 (p &lt; 0.001). Conclusions: In this preliminary cohort, non-thermal adenotonsillar ablation using irreversible electroporation was safe, well tolerated, and demonstrated short-term improvements in parent-reported symptoms and oropharyngeal tonsillar size in children. These findings support further investigation in larger, multicenter trials with extended follow-ups.<\/jats:p>","DOI":"10.3390\/jcm15135189","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T14:51:25Z","timestamp":1783003885000},"page":"5189","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Irreversible Electroporation for the Treatment of Pediatric Adenotonsillar Hypertrophy"],"prefix":"10.3390","volume":"15","author":[{"given":"Ulugbek","family":"Khasanov","sequence":"first","affiliation":[{"name":"Republican Specialized Scientific and Practical Center of Otorhinolaryngology and Head and Neck Diseases, Tashkent 100084, Uzbekistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zukhrob Sobirjonovich","family":"Matmuratov","sequence":"additional","affiliation":[{"name":"Republican Specialized Scientific and Practical Center of Otorhinolaryngology and Head and Neck Diseases, Tashkent 100084, Uzbekistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru","family":"Coman","sequence":"additional","affiliation":[{"name":"\u201cM. S. Curie\u201d Emergency Clinical Hospital for Children, 077120 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei Mihai","family":"Buruian\u0103","sequence":"additional","affiliation":[{"name":"\u201cM. S. Curie\u201d Emergency Clinical Hospital for Children, 077120 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4791-012X","authenticated-orcid":false,"given":"Desiderio","family":"Passali","sequence":"additional","affiliation":[{"name":"ENT Clinic, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Maria","family":"Passali","sequence":"additional","affiliation":[{"name":"Department Clinical Sciences and Translational Medicine, University of Rome \u201cTor Vergata\u201d, 00133 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4439-629X","authenticated-orcid":false,"given":"Ari","family":"DeRowe","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Tel Aviv Sourasky University Medical Center, Gray Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"ref_1","first-page":"S1","article-title":"Clinical Practice Guideline: Tonsillectomy in Children (Update)","volume":"160","author":"Mitchell","year":"2019","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1002\/ohn.268","article-title":"Estimations of Inpatient and Ambulatory Pediatric Tonsillectomy in the United States: A Cross-sectional Analysis","volume":"169","author":"Johnson","year":"2023","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1002\/ohn.573","article-title":"Postoperative Outcomes of Intracapsular Tonsillectomy with Coblation: A Systematic Review and Meta-Analysis","volume":"170","author":"Lin","year":"2024","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1002\/lary.20024","article-title":"Comparison of three common tonsillectomy techniques: A prospective randomized, double-blinded clinical study","volume":"119","author":"Wilson","year":"2009","journal-title":"Laryngoscope"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1002\/lary.31116","article-title":"Postoperative Morbidity of Different Tonsillectomy Techniques: A Systematic Review and Network Meta-Analysis","volume":"134","author":"Russo","year":"2024","journal-title":"Laryngoscope"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1002\/lary.26886","article-title":"The safety and efficacy of powered intracapsular tonsillectomy in children: A meta-analysis","volume":"128","author":"Lee","year":"2018","journal-title":"Laryngoscope"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1146\/annurev-biophys-052118-115451","article-title":"Membrane Electroporation and Electropermeabilization: Mechanisms and Models","volume":"48","author":"Kotnik","year":"2019","journal-title":"Annu. Rev. Biophys."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1016\/j.jacep.2023.03.014","article-title":"Catheter-Based Electroporation: A Novel Technique for Catheter Ablation of Cardiac Arrhythmias","volume":"9","author":"Tabaja","year":"2023","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Spiers, H.V.M., Lancellotti, F., de Liguori Carino, N., Pandanaboyana, S., Frampton, A.E., Jegatheeswaran, S., Nadarajah, V., and Siriwardena, A.K. (2023). Irreversible Electroporation for Liver Metastases from Colorectal Cancer: A Systematic Review. Cancers, 15.","DOI":"10.3390\/cancers15092428"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"George, A.K., Miocinovic, R., Patel, A.R., Lomas, D.J., Correa, A.F., Chen, D.Y.T., Rastinehad, A.R., Schwartz, M.J., Uchio, E.M., and Sidana, A. (2024). A Description and Safety Overview of Irreversible Electroporation for Prostate Tissue Ablation in Intermediate-Risk Prostate Cancer Patients: Preliminary Results from the PRESERVE Trial. Cancers, 16.","DOI":"10.3390\/cancers16122178"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Sarafoleanu, C., Tanase, I., Pascu, M.A., Passali, D., and DeRowe, A. (2026). Irreversible Electroporation for Tonsillar Ablation in Adults. Otolaryngol. Head Neck Surg., ahead of print.","DOI":"10.1002\/ohn.70276"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1001\/jamaoto.2014.2338","article-title":"The reliability of clinical tonsil size grading in children","volume":"140","author":"Kumar","year":"2014","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1001\/jamaoto.2024.4373","article-title":"Symptoms, Quality of Life, and Executive Function in Children Who Snore","volume":"151","author":"Yu","year":"2025","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1111\/pan.14407","article-title":"Validation of the parent\u2019s postoperative pain measure with an age-appropriate reference pain scale for children 2\u201312 years old during a 14-day recovery after tonsillectomy: A prospective cohort study","volume":"32","author":"Brown","year":"2022","journal-title":"Paediatr. Anaesth."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1148\/radiol.2020192190","article-title":"High-Voltage Electrical Pulses in Oncology: Irreversible Electroporation, Electrochemotherapy, Gene Electrotransfer, Electrofusion, and Electroimmunotherapy","volume":"295","author":"Geboers","year":"2020","journal-title":"Radiology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e0166987","DOI":"10.1371\/journal.pone.0166987","article-title":"Time-Dependent Impact of Irreversible Electroporation on Pancreas, Liver, Blood Vessels and Nerves: A Systematic Review of Experimental Studies","volume":"11","author":"Vogel","year":"2016","journal-title":"PLoS ONE"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/13\/5189\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T10:09:22Z","timestamp":1783937362000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/13\/5189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":16,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["jcm15135189"],"URL":"https:\/\/doi.org\/10.3390\/jcm15135189","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]}}}