Quality of life after tonsillectomy in adult patients with recurrent acute tonsillitis: a systematic review

Houborg, Hannah Inez; Klug, Tejs Ehlers

doi:10.1007/s00405-022-07260-7

Cited by 6 publications

(4 citation statements)

References 38 publications

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“…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.

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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.

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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.

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“…To our knowledge, no previous studies have been conducted aiming to compare different guidelines/sets of criteria for tonsillectomy in RT patients. We recently published a systematic review of studies exploring TR-QOL in RT patients 17 : 4 studies 10,12-14 found mean GBI scores in the range 18.2 to 39.9; 6 to 14 months after tonsillectomy. Douglas et al 14 studied 70 patients using the SIGN criteria for inclusion, and similar to our findings among G3 patients, they reported a mean GBI total score of 39.9 with high levels of improvement in the general health (42.5) and the physical health domain (57.4), but less improvement in the social support domain (11.9).…”

Section: Discussionmentioning

confidence: 99%

“…Recurrent acute tonsillitis (RT) is the prevalent indication for tonsillectomy in adult and well-documented advantages of surgery include decreased incidence of throat infections and associated doctor visits and days of sick leave, reduced use of antibiotics, economic benefits, and improved quality of life. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The criteria for selecting patients with RT for tonsillectomy remain unsettled and different guidelines are used internationally (Table 1). Many national guidelines are inspired by the Paradise et al 18 criteria, which are based on the results of a study from 1984 including 187 children.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Guidelines For Tonsillectomy in Adults With Recurrent Acute Tonsillitis

Houborg

Klug

2023

Ann Otol Rhinol Laryngol

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Objectives: The criteria for selecting patients with recurrent acute tonsillitis (RT) for tonsillectomy remain unsettled and different guidelines are used internationally. We aimed to evaluate currently used guidelines for tonsillectomy in adults with RT and identify the best predictive parameters for improved throat-related quality of life (TR-QOL) after surgery. Methods: About 66 RT patients undergoing tonsillectomy was prospectively included and categorized into 3 groups based on which guideline(s) they met: Group 1: patients not meeting any of the Danish/Paradise/Scottish Intercollegiate Guideline Network (SIGN) guidelines. Group 2: patients meeting the Danish guidelines. Group 3: patients meeting the Paradise and/or the SIGN guidelines. TR-QOL was assessed using the Tonsillectomy Outcome Inventory 14 (TOI-14) before and 6 months after tonsillectomy as well as the Glasgow Benefit Inventory (GBI). Predictive parameters for improved TR-QOL were investigated using multiple linear regression. Results: About 61 (92%) patients completed the questionnaires. Patients in all groups had significant TR-QOL improvements (Group 1 (n = 20): ΔTOI-14 31.1; GBI 29.4; Group 2 (n = 31): ΔTOI-14 32.0; GBI 36.4; Group 3 (n = 10): ΔTOI-14 45.6; GBI 39.7) and satisfaction rates were high (94%-100%). Preoperative TOI-14 score was the best predictor for improved TR-QOL ( P < .001, R2 = .80), followed by the number of tonsillitis episodes with physician verification within the previous 12 months ( P = .002, R2 = .25). Conclusions: Patients in all groups experienced massive TR-QOL improvements suggesting that currently used guidelines may be too restrictive. Preoperative TOI-14 score was the best parameter for predicting TR-QOL improvement, and this tool may be useful in the selection of adults with RT for tonsillectomy.

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

Plath

Sand

Behnen

et al. 2022

Eur Arch Otorhinolaryngol

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Quality of life after tonsillectomy in adult patients with recurrent acute tonsillitis: a systematic review

Cited by 6 publications

References 38 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

Evaluation of Guidelines For Tonsillectomy in Adults With Recurrent Acute Tonsillitis

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

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