Selection of indicators for tonsillectomy in adults with recurrent tonsillitis

Kasenõmm, Priit; Piirsoo, Andres; Kull, Mart; Mikelsaar, Marika

doi:10.1186/1472-6815-5-7

Cited by 16 publications

(19 citation statements)

References 26 publications

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“…Although the indication for tonsillectomy in groups with hypertrophied tonsils in obstructive sleep apnoea and some malignancies is undisputed, there is some controversy with respect to recurrent or chronic tonsillitis. A number of studies confirming the indications and benefits of tonsillectomy in childhood are available 6–9 ; however, there is a relative paucity of findings in an adult group 10–12 . There is a need for evidence‐based results to guide referral patterns and aid selection of appropriate candidates for operative management.…”

Section: Discussionmentioning

confidence: 99%

“…A number of studies confirming the indications and benefits of tonsillectomy in childhood are available [6][7][8][9] ; however, there is a relative paucity of findings in an adult group. [10][11][12] There is a need for evidence-based results to guide referral patterns and aid selection of appropriate candidates for operative management. Our study examines whether young adults with an accepted indication for tonsillectomy are afforded quality-of-life benefits postprocedure.…”

Section: Discussionmentioning

confidence: 99%

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Quality‐of‐life Effect of Tonsillectomy in a Young Adult Group

Richards

Bailey

Hooper

et al. 2007

ANZ Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Quality‐of‐life Effect of Tonsillectomy in a Young Adult Group

Richards

Bailey

Hooper

et al. 2007

ANZ Journal of Surgery

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“…In addition, macroscopic oropharyngeal signs were evaluated and the index of tonsillitis (IT) was calculated as described in our previous studies ( 12 , 13 ). Macroscopic oropharyngeal signs were evaluated on tonsill in the opposite side of PTA and they were as follows: tonsillar sclerosis, obstruction of the tonsillar crypts, scar tissue on tonsils, cryptic debris, and lymphatic tissue aggregates.…”

Section: Methodsmentioning

confidence: 99%

Microbiology of peritonsillar abscess in the South Estonian population

Vaikjärv

Kasenõmm

Jaanimäe

et al. 2016

Microbial Ecology in Health & Disease

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ObjectiveThe first aim of this study was to compare the microbiota of different locations (pus, tonsillar fossa, blood) in peritonsillar abscess (PTA) patients in order to optimize the sampling scheme. The second aim was to estimate the occurrence of tonsillitis episodes and macroscopic oropharyngeal signs characteristic of recurrent tonsillitis in PTA patients.MethodsThe study group consisted of 22 consecutive patients with PTA undergoing bilateral tonsillectomy. The PTA was punctured; pus and tonsillar fossa biopsy samples and the peripheral blood cultures were collected. The index of tonsillitis was calculated by multiplying the number of tonsillitis episodes per year by the morbidity period in years. Macroscopic oropharyngeal signs were evaluated and they were as follows: tonsillar sclerosis, obstruction of the tonsillar crypts, scar tissue on tonsils, cryptic debris, and lymphatic tissue aggregates.ResultsThe cultures of the pus were positive in 16 out of 22 patients and the cultures of the tonsillar fossa samples were positive in all cases. In total, 62 different organisms were found from tonsillar fossa, pus, and blood samples, which belonged to 5 different phyla and 18 different families.In the tonsillar fossa, the most frequent bacteria found were Streptococcus spp. In pus samples, the most frequently found bacteria were Streptococcus spp. and bacteria from the Streptococcus milleri group.ConclusionPTA patients had mixed anaerobic and aerobic microbiota both in the tissue of the tonsillar fossa and the pus of the peritonsillar space. We demonstrated that the tonsillar fossa specimen is a better material for microbiological analyses, because it reveals more bacteria per culture. PTA patients usually have a low number of tonsillitis episodes in their previous history, but a relatively high number of macroscopic oropharyngeal signs, indicating the sclerotic process in palatal tonsils.

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“…Recently, an index of tonsillitis was proposed including the factors tonsillitis episodes, morbidity period, presence of sclerotic signs like tonsillar sclerosis, scar tissue formation and obstruction of tonsillar crypts, and assessment of streptococcus pyogenes in cultures or by PCR [10]. Clinical studies validating the effectiveness of this index to predict the outcome is, however, lacking.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance and diagnostic usefulness of serologic markers for improvement of outcome of tonsillectomy in adults with chronic tonsillitis

Bohne

Siggel

Sachse

et al. 2013

J Negat Results BioMed

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BackgroundThe aim of the present study was to explore serological biomarkers which predict the outcome of tonsillectomy for chronic tonsillitis.MethodsA case study in a University ENT department of 24 adult patients with chronic tonsillitis (CHT) in comparison to 24 patients with acute peritonsillar abscess (PTA) was performed. Blood samples for clinical routine hematological and serological parameters were assessed prior to surgery (T-1) and five days (T5) after tonsillectomy. Outcome 6 months later (T180) was documented using the Glasgow Benefit Inventory (GBI) and the Specific Benefits from Tonsillectomy Inventory (SBTI). Correlation analyses between CHT and PTA group as well as between the different time points within each group concerning the serological parameters and the outcome parameters were performed.ResultsAt T-1, patients in the CHT group presented with significantly higher lymphocytes counts (relative and absolute), basophils (relative and absolute) and eosinophils but less white-cells, monocytes, neutrophils (absolute and relative), alpha-1, alpha-2, beta globulins, immunoglobulin and lower C-reactive protein and procalcitonin values than patients in the PTA group (all p < 0.05, respectively). Within each group, different significant changes of the serum parameters (often in opposite direction) were observed between T-1 and T5. SBTI scores at T-1 were significantly lower in the CHT group. In contrast, most GBI scores at T180 were significantly higher in the CHT group. Between T-1 and T180 the SBTI scores improved in three quarters of the CHT patients but only in three fifths of the PTA patients. Higher eosinophil counts and immunoglobulin E levels at T-1 predicted higher GBI scores at T180 in the CHT group.ConclusionsThis pilot study showed a specific serological pattern for patients with chronic tonsillitis with a specific pattern of changes after tonsillectomy. But there is no established role for biomarkers currently used in clinical practice to predict the outcome of tonsillectomy for chronic tonsillitis.

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Selection of indicators for tonsillectomy in adults with recurrent tonsillitis

Cited by 16 publications

References 26 publications

Quality‐of‐life Effect of Tonsillectomy in a Young Adult Group

Quality‐of‐life Effect of Tonsillectomy in a Young Adult Group

Microbiology of peritonsillar abscess in the South Estonian population

Clinical significance and diagnostic usefulness of serologic markers for improvement of outcome of tonsillectomy in adults with chronic tonsillitis

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