Objective: to compare two techniques for tonsil surgery with respect to postoperative pain and morbidity and changes in sleep, behavior, health related quality of life (HRQL) and benefit due to  surgery.

Methods: 67 pre-school children  with  tonsillar hypertrophy were randomized to regular tonsillectomy (TE)  or tonsillotomy (TT) with Radiofrequency surgical technique.

The parents completed a validated quality of life  survey, Obstructive Sleep Apnea-18 (OSA18) , assessed the children’s behavior  with the Child Behavior Checklist (CBCL) before and six month after surgery and evaluated the post-operative  health related benefits using the Glasgow Children’s Benefit Inventory (GCBI).

Results: TT-children recorded less pain from the first day, and were pain-free 3 days earlier than TE-children. Six months post-surgery, there was no difference between TT and TE with regard to snoring and ENT-infections.

The total scores in all the individual domains between the initial OSA-18 and post-surgery scores differed (p<0.0001). Improvement in CBCL score was also significant (p<0.01) . There were no differences between TT- and TE-children. GCBI indicated a significant health benefit of both methods.

Conclusions: Tonsillar hypertrophy  shows  impact on HRQL and behavior. After  tonsillar operation, improvements occur as much after TT as after TE.  TT should be first choice for treatment.