Does a tonsillectomy indicated according to the German S2k guideline affect short-term quality of life in adults?

Plath, Michaela; Sand, Matthias; Behnen, Kjell; Plath, Karim; Baumann, Ingo

doi:10.1007/s00405-022-07758-0

Cited by 2 publications

(2 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both questionnaires are partly validated in several languages for adults and children (English, Spanish, German, Arabic, Finnish) ( 37 – 40 ). The benefit of tonsillectomy in gaining quality of life is higher in patients with higher number of tonsillitis episodes before surgery ( 41 , 42 ).…”

Section: Resultsmentioning

confidence: 99%

Treatment of recurrent acute tonsillitis—a systematic review and clinical practice recommendations

Guntinas-Lichius,

Geißler,

Mäkitie

et al. 2023

Front. Surg.

View full text Add to dashboard Cite

BackgroundThere is an ongoing debate on the indications for tonsil surgery in both children and adults with recurrent acute tonsillitis. The aim is to provide practical recommendations for diagnostics and treatment for recurrent acute tonsillitis including evidence-based decision making for tonsillectomy.MethodsA systematic literature search in PubMed, Embase, Web of Science, and ScienceDirect from 2014 until April 2023 resulted in 68 articles. These were the basis for the review and a comprehensive series of consensus statements on the most important diagnostics and indications for both non-surgical and surgical therapy. A consensus paper was circulated among the authors and members of the International Head and Neck Scientific Group until a final agreement was reached for all recommendations.ResultsThe differentiation between sore throat and tonsillitis patient episodes is mostly not feasible and hence is not relevant for diagnostic decision making. Diagnostics of a tonsillitis/sore throat episode should always include a classification with a scoring system (Centor, McIssac, FeverPAIN score) to estimate the probability of a bacterial tonsillitis, mainly due to group A streptococcus (GAS). In ambiguous cases, a point-of-care test GAS swab test is helpful. Consecutive counting of the tonsillitis/sore throat episodes is important. In addition, a specific quality of life score (Tonsillectomy Outcome Inventory 14 or Tonsil and Adenoid Health Status Instrument) should be used for each episode. Conservative treatment includes a combination of paracetamol and/or non-steroidal anti-inflammatory drugs. In case of high probability of bacterial tonsillitis, and only in such cases, especially in patients at risk, standard antibiotic treatment is initiated directly or by delayed prescription. Tonsillectomy is indicated and is highly effective if the patient has had ≥7 adequately treated episodes in the preceding year, ≥5 such episodes in each of the preceding 2 years, or ≥3 such episodes in each of the preceding 3 years. An essential part of surgery is standardized pain management because severe postoperative pain can be expected in most patients.ConclusionIt is necessary to follow a stringent treatment algorithm for an optimal and evidence-based treatment for patients with recurrent acute tonsillitis. This will help decrease worldwide treatment variability, antibiotic overuse, and avoid ineffective tonsillectomy.

show abstract

Section: Resultsmentioning

confidence: 99%

Treatment of recurrent acute tonsillitis—a systematic review and clinical practice recommendations

Guntinas-Lichius,

Geißler,

Mäkitie

et al. 2023

Front. Surg.

View full text Add to dashboard Cite

show abstract

“…A further increase of guideline adherence in daily routine can be expected with continuous medical education concerning the guideline 15 , and mainly by increasing evidence that RAT patients in any age group with ≥ 6 episodes really profit more from tonsil surgery than patients with less severe symptoms 16 – 18 . In this regard, the recently published results of the Tonsillectomy IN Adults (NATTINA) are very important 19 .…”

Section: Discussionmentioning

confidence: 99%

Effect of the German tonsillitis guideline on indication for tonsil surgery in patients with recurrent acute tonsillitis: a population-based study

Betz,

Boeger,

Buentzel

et al. 2023

Sci Rep

View full text Add to dashboard Cite

Evidence-based indication for tonsil surgery in patients with recurrent acute tonsillitis (RAT) is an ongoing matter of debate. Since introduction of the German tonsillitis guideline in 2015, the indication criteria for tonsil surgery have become much stricter. It is unclear, if this has changed the indication policy. A retrospective population-based study was performed including all 1398 patients with RAT admitted for tonsil surgery in all Thuringian hospitals in 2011, 2015, and 2019. Changes over the years concerning patients’ characteristics, number of tonsillitis episodes in the last 12 months treated with antibiotics (T12), and decision for tonsillectomy or tonsillotomy were analyzed using univariable and multivariable statistics. The surgical rates decreased from 28.56/100,000 population in 2011 to 23.57 in 2015, and to 11.60 in 2019. The relative amount of patients with ≥ 6 T12 increased from 14.1% in 2011 over 13.3% in 2015 to 35.9% in 2019. Most patients received a tonsillectomy (98% of all surgeries). Decision for tonsillotomy was seldom (1.2%). Multinomial logistic regression analysis with the year 2011 as reference showed that compared to the year 2015, the age of the patients undergoing surgery increased in 2015 (Odds ratio [OR] = 1.024; 95% confidence interval [CI] = 1.014–1.034; p < 0.001), and also in 2019 (OR 1.030: CI 1.017–1.043; p < 0.001). Compared to 2011, the number T12 was not higher in 2015, but in 2019 (OR 1.273; CI 1.185–1.367; p < 0.001). Stricter rules led to lower tonsil surgery rates but to a higher proportion of patients with ≥ 6 T12 before surgery. Tonsillectomy remained the dominating technique.

show abstract

Does a tonsillectomy indicated according to the German S2k guideline affect short-term quality of life in adults?

Cited by 2 publications

References 22 publications

Treatment of recurrent acute tonsillitis—a systematic review and clinical practice recommendations

Treatment of recurrent acute tonsillitis—a systematic review and clinical practice recommendations

Effect of the German tonsillitis guideline on indication for tonsil surgery in patients with recurrent acute tonsillitis: a population-based study

Contact Info

Product

Resources

About