Patient Attitudes to Tonsillectomy

Abstract

Introduction. Recent changes to primary care trusts' Procedures of Limited Clinical Value (PLCV) policy mean that otolaryngologists must now follow policy rather than exercising clinical judgment when listing patients for tonsillectomy. Objectives. To gauge perception within the general public of when tonsillectomy is acceptable and to compare this to the current policy. Method. All patients or their parents attending the adult and paediatric outpatient ENT departments were asked to anonymously complete questionnaires. Results. One hundred and twenty-five completed questionnaires were collected. Thirty-one percent of respondents thought tonsillectomy should be offered solely on patient request, 19% after one to three bouts, and 35% after four to six bouts of tonsillitis. Only 9% thought the current guidelines were reasonable. Patients who had suffered recurrent tonsillitis or had undergone previous tonsillectomy generally thought tonsillectomy advisable after more bouts of tonsillitis than those who had not. Fourteen patients fulfilled the SIGN guidelines for tonsillectomy for recurrent tonsillitis. Of these, 13 (93%) felt that suffering 4–6 bouts of tonsillitis was reasonable before tonsillectomy. Conclusion. All patients we surveyed who meet the current PLCV and SIGN guidelines regarding the appropriateness of tonsillectomy for recurrent tonsillitis perceive that they are excessive, believing that 4–6 bouts of recurrent tonsillitis are adequate to justify tonsillectomy.

Awareness and Perceptions of the Impact of Tonsillectomy on the Level of Immunity and Autoimmune Diseases among the Adult Population in Abha City, Kingdom of Saudi Arabia

“…Around 39.2% of patients with tonsillectomy have a family income of up to 9000 SAR, suggesting a lower middle class, which is also supported by research showing that twice as many children with age <16 years belong to the lower socioeconomic class [ 11 , 18 , 19 ]. However, household income showed a weak association with tonsillectomy in many other studies [ 20 , 21 ].…”

Evaluation of Guidelines For Tonsillectomy in Adults With Recurrent Acute Tonsillitis

“…20,21 Studies report that patients experience poor throat-related quality of life (TR-QOL) for years until they finally meet the SIGN criteria and undergo tonsillectomy. 14,20 Patients often find the guidelines unreasonable and prefer tonsillectomy at an earlier stage than recommended, 22,23 and physicians occasionally offer RT patients tonsillectomy even though guidelines are not strictly met. [24][25][26][27] In Denmark, the less strict Danish national guidelines (DNG) are used.…”