Tympanostomies and tonsillar surgery in children during the COVID-19 pandemic in Finland

Marjut Haapanen, Marjo Renko, Miia Artama, Iida Kaisa Manninen, Ville M. Mattila, Mikko Uimonen, Ville Ponkilainen, Ilari Kuitunen

Research output: Contribution to journalArticleScientificpeer-review


Objective: To assess the impact of social restrictions due to COVID-19 on the number of tympanostomies and tonsillar surgeries in children. Methods: Incidences were calculated per 100 000 children for tonsillar surgery and tympanostomies in 2020 and compared to the mean incidence of referral years 2017 to 2019 by incidence rate ratios (IRR) with 95% confidence intervals (CIs). Median waiting times were also compared. Results: Before the lockdown, tonsillar surgery incidence was 33.4/100000 (IRR 1.14, CI 0.76-1.71) in February 2020. After the lockdown began, the incidence of tonsillar surgery was 1.4/100000 (IRR 0.04, CI 0.01-0.15) in April. In June, tonsillar operation incidence started to increase (20.4 per 100 000). The incidence of tympanostomies was 81% lower (IRR 0.19, CI 0.09-0.39) in April 2020 and 61% lower (IRR 0.39, CI 0.22-0.69) in August 2020 than in 2017-2019. These incidence rates remained lower all year (December 2020 IRR 0.13, CI 0.05-0.33). Median waiting time for tonsillar surgery was 3.3 months in 2020 and 1.6 months in 2017 to 2019; P <.001, and for tympanostomies 1.3 months in 2020 and 1.0 months in 2017 to 2019, P <.001. The referral rate to otorhinolaryngology during the severest restrictions was 35% lower in April and May 2020 compared with the reference years. Conclusion: This study suggests that the restrictions against COVID-19 reduced the incidence rates of tonsil surgery and tympanostomies in children. Also, the lockdown and cancellations of elective operations in spring 2020 led to increased waiting times. These findings may help in preparing for future pandemics. Level of evidence: Level 3.

Original languageEnglish
Pages (from-to)878-884
Number of pages7
JournalLaryngoscope Investigative Otolaryngology
Issue number4
Publication statusPublished - 2021
Publication typeA1 Journal article-refereed


  • coronavirus disease 2019
  • lockdown
  • tonsil surgery
  • tympanostomy tubes

Publication forum classification

  • Publication forum level 0

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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