Does tonsillectomy reduce medical care visits for pharyngitis/tonsillitis in children and adults? Retrospective cohort study from Sweden

Abstract

ObjectiveTo assess the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis or tonsillitis in children and adults with chronic/recurrent tonsillitis.DesignRetrospective cohort study.SettingData were retrieved from the VEGA register, a comprehensive regional cohort in Sweden.Participants1044 children (<15 years) and 2244 adults.InterventionTonsillectomy/adenotonsillectomy compared with no surgical treatment.Main outcome measuresChanges in yearly mean rates of medical care visits due to pharyngitis/tonsillitis.ResultsIn children, there was a significant decrease in the yearly mean medical care visits rate from 1.93 (1.82 to 2.04) before surgery to 0.129 (0.099 to 0.165) after surgery, with a mean change of −1.80 (−1.90 to −1.69), p<0.0001. In patients who did not undergo surgery, the corresponding mean change was −1.51 (−1.61 to −1.41), resulting in a mean difference in the change in visit rates between the intervention and control groups of −0.283 (−0.436 to −0.135), p=0.0002. In adults, a significant decrease in the yearly mean medical care visit rate was observed from 1.45 (1.39 to 1.51) before surgery to 0.152 (0.132 to 0.173) after surgery, with a mean change of −1.30 (−1.36 to −1.24), p<0.0001, compared with −1.18 (−1.24 to −1.13) in the control group. The difference in the change in yearly mean visit rate between the surgical and non-surgical groups was −0.111 (−0.195 to −0.028), p=0.0097. The subgroup analysis showed a greater effect of surgery in children, in patients with a higher number of medical care visits before surgery and in the first year of follow-up.ConclusionIn this cohort of patients moderately or less affected with chronic/recurrent tonsillitis, the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis and tonsillitis compared with no surgical treatment was low and of questionable clinical value.

Comparison of clinical practice of tonsil surgery from quality register data from Sweden and Norway and one clinic in Denmark

“…The Paradise criteria are referred to for the indications for surgery in all three countries guidelines, but the Swedish guidelines are phrased so that only three infections can qualify for surgery 8. A study confirmed that few patients in Sweden seem to meet the Paradise criteria 22 23. However, the criteria cover only recurrent tonsillitis and not surgical indications for chronic tonsillitis.…”

A case report of reccurent attack of acute tonsilitis treated with psorinum 1M: A case report

“…Tonsilitis is an inflammation of the tonsils. It is a viral infection and sometimes it may bacterial also [1,2] . The common symptoms of tonsilitis is sore throat, fever, enlargement of the tonsils, trouble in swallowing and lymphadenopathy [3,4] .…”