Does tonsillectomy lead to improved outcomes over and above the effect of time? A longitudinal study

Abstract

The morbidity reported by patients suffering from chronic, untreated tonsillitis decreases with time. Tonsillectomy produces significantly greater reductions in morbidity than time alone.

Tonsillectomy for Obstructive Sleep-Disordered Breathing: A Meta-analysis

“…Many young patients may outgrow the need for intervention, but more data are needed to describe the potential to outgrow these indications to parents and to describe population factors that may predict resolution. 20,33,34 Long-term data are needed to enable caregivers to weigh the benefits of surgery versus the reality of managing their child's condition as they wait for it to resolve, although obtaining longer-term data is difficult.…”

Indications for tonsillectomy stratified by the level of evidence

“…This finding contrasts to reports of Lock et al who also registered a better outcome in children between 4 and 15 years of age after TE [401], [414]. One of the trials cited by Barraclough and Anari was not randomized and controlled and quantified postoperative satisfaction of the parents and quality of life, psychological changes and impact on the body growth in operated children [415], [416], [417], [418], [419], [420], [421], [422], [423], [424], [425], [426], [427], [428], [429], [430]. Only 6/16 studies focussed on sore throat, 3 of them did not discuss the issue [419], [429], [431].…”

“…Those specific symptoms as well as the quality of life were described as having clearly improved in this population [416]. Barraclough and Anari refer to a publication by Blakley and Magit [426] stating that surgical therapy reduced the number of pharyngitis episodes by 43%, however, the effect is more than moderate compared to conservative therapy.…”

“…Simple measures have been suggested to improve the documentation system [441]. Die to the potential of spontaneous healing [402], [403], [404], [426], [433], [437], [442], [443], [444], [445], [446] a wait-and-see policy for 12 months is recommend prior to indicate TE. Patients with repeated inpatient treatment of tonsillitis, Lemierre’s syndrome, PTA, or a family history of rheumatic fever with cardiac or renal involvement are not subject of this recommendation.…”

“…Based on the American guideline, children with SBD are good candidates for TE or TOTO [475]. Concerning recurrent tonsillitis episodes, the authors cited the most significant papers [434], [436], [447], [477] and stressed the low data quality and positive reports concerning an improved quality of life and high postoperative patient satisfaction after TE [416], [426], [429], [478], [479]. The contents of the RCTs of Paradise et al [403], [404] and van Staaij et al [402] were briefly described.…”