gms | German Medical Science

Different surgical techniques are used to treat hypertrophy of the palatal tonsils. One of recently very popular surgical methods preserving the tonsillar capsule and partially lymphoid tissue is Radiofrequency Induced Thermo Therapy (RFITT). So far there is very limited information on morphologic or functional changes in the human tonsil after RFITT. Hence we collected tonsillectomy specimens after RFITT and performed histopathological examination comparing these cases to standard tonsillectomy ones.

We treated 38 patients (12 males and 26 females; median age, 23 years; age range 12–40 years) by RFITT of the tonsils from December 2005 till October 2007. Three patients with an insufficient volume reduction (measured by 3D ultrasound) as well as poor subjective assessment subsequently underwent traditional cold-steel bilateral tonsillectomy under general anesthesia. Profound histopathological examination was performed to determine the effect of RFITT on tonsillar architecture.

The average volume reduction of the tonsil in all treated patients was 38%. Only three female patients were recommended for subsequent standard tonsillectomy. Their tonsillar volume reduction were 12% on the left side and 17% on the right side for the case No. 1, 6% and 19% for the case No. 2, and 0% and 9% for the case No. 3. Histopathological examination was analogical in all tonsillectomy specimens. The tonsillar epithelium preserved a normal structure of the multilayer squamous epithelium. Submucosally there were no signs of increased fibrosis corresponding to the scarification. Architecture of the lymphoid germinal centers was also normal.

No morphological changes in tonsillectomy specimens after RFITT sustain the assumption of no functional adverse changes after this kind of surgery.