Application of the paediatric throat disorders outcome test (T-14) for tonsillectomy and adenotonsillectomy

Abstract

Introduction The T-14 questionnaire is a validated patient reported outcome measure (PROM) used to assess the value of paediatric tonsillectomy from the patient’s perspective. Tonsillectomy is a procedure under threat. As such, this study aimed to provide further evidence supporting the role of tonsillectomy in the management of recurrent tonsillitis and obstructive sleep apnoea. Methods A prospective uncontrolled observational study was undertaken examining 54 paediatric patients undergoing tonsillectomy at our institution. Parents of children having surgery were invited to complete a T-14 questionnaire preoperatively as well as at three and six months postoperatively. Results The questionnaire was completed for 52 of the 54 patients preoperatively as well as at 3 and 6 months postoperatively (96% response rate). The mean difference between the preoperative and six-month T-14 score was 31.8 (p<0.0001). T-14 scores at three months were also significantly improved compared with those taken preoperatively (mean difference: 29.9, p<0.0001). Conclusions This is the first study in the literature to assess T-14 questionnaires at three and six months following paediatric tonsillectomy, providing evidence of the early benefit on PROMs. Tonsillectomy is the most common surgical procedure performed in the UK, and it is regarded highly by patients and otolaryngologists alike. This study provides significant evidence that tonsillectomy improves PROMs, thereby demonstrating its ongoing clinical value as a funded National Health Service procedure.

Coblation® intracapsular tonsillectomy (tonsillotomy) in children: A prospective study of 500 consecutive cases with long‐term follow‐up

“…12 In our series of 500 prospectively assessed paediatric Coblation â IT cases, we have shown excellent validated parent-reported symptomatic improvements for obstructive and infective domains. These compare favourably with equivalent figures published for ET, 13 with added benefits of rapid recovery, minimal simple analgesic requirements and very low rates of haemorrhage. Our postoperative direct follow-up period extends to 2.4 years, considerably longer than many studies in the literature.…”

Our experience. Coblation® intracapsular tonsillectomy (tonsillotomy) in children: a prospective study of 100 consecutive cases

“…In one hundred prospectively assessed, consecutive tertiary paediatric cases, we have demonstrated excellent results in terms of symptom resolution (using the validated T14 tool), rapid recovery, no unexpected delayed discharges, and no haemorrhages or other serious complications. The symptomatic improvements compare favourably with equivalent published figures for extracapsular tonsillectomy . None required additional analgesia, particularly pertinent given the July 2013 MHRA ruling which contraindicates the use of codeine in under‐12s and in all under‐18s with OSA…”

Scoping review of pediatric tonsillectomy quality of life assessment instruments

“…Additionally, further psychometric testing demonstrated high internal consistency (Cronbach α = .84), test–retest reliability, and responsiveness to change . Three of the included studies in this scoping review utilized the T‐14 questionnaire to investigate QoL following tonsillectomy, whereas two of the studies compared the QoL effects of tonsillectomy against watchful waiting …”