Tonsillitis index: An objective tool for quantifying the indications for tonsillectomy for recurrent acute tonsillitis

Fujihara, Kazuo; Goto, Hironobu; Hiraoka, Masanobu; Hotomi, Muneki; Tamura, Shinji; Kuki, Kiyonori; Yamanaka, Noboru; Koltai, Peter J.

doi:10.1016/j.ijporl.2005.04.007

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…Multiple round or elongated yellow-coloured patches on the retropharyngeal mucosa were described as lymphatic tissue aggregates, which are presumably due to enlargement of normal lymphatic structures in the throat. The IT score was calculated by multiplying the number of tonsillitis episodes per year by the morbidity period in years ( 14 ). Basically, it represents the total number of tonsillitis episodes the patient has ever had.…”

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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Section: Methodsmentioning

confidence: 99%

Microbiology of peritonsillar abscess in the South Estonian population

Vaikjärv

Kasenõmm

Jaanimäe

et al. 2016

Microbial Ecology in Health & Disease

View full text Add to dashboard Cite

show abstract

“…Tonsil infections are defined by three of the following criteria: fever (>101 8F), dysphagia, cervical adenopathy, positive GABHS culture, and tonsillar exudates [8]. In Japan, the consensus indication is four episodes in each of 2 successive years [9]. On the other hand, some authors believe that recommendations for tonsillectomy should be based on evaluation of the child's overall health status and quality of life and not just the number of culture-documented tonsil infections [10].…”

Section: Discussionmentioning

confidence: 99%

“…Their results suggest that when TI ! 8, there is a reasonable indication for tonsillectomy [9]. While there is no worldwide agreement about the exact number of attacks of AT warranting tonsillectomy, and considering the above-mentioned controversies, the question arises as to whether these data are applicable to children in different geographical areas of Iran regarding the differences in the cultural, social and demographic characteristics of the patients.…”

Section: Discussionmentioning

confidence: 99%

“…In both children and adults, recurrent pharyngitis is a frequent reason for referral and surgery. Surprisingly, there is actually very limited evidence on the effectiveness of tonsillectomy for the treatment of recurrent pharyngitis [8,9,11]. In a recent Cochrane review to elicit the effect of tonsillectomy on the treatment of chronic or recurrent acute tonsillitis by Burton et al, no indication of the effectiveness of tonsillectomy was reached [7].…”

Section: Discussionmentioning

confidence: 99%

“…Most other studies on children have been retrospective, have also generally used the number of infections as a main outcome; all of these studies tend to show significant improvements in disease-specific and global quality of life after T&A. Furthermore, they experienced fewer infections, doctor visits, and courses of antibiotics after T&A [8][9][10][11]. Also, in a prospective study of adults with recurrent or chronic tonsillitis, significant improvements in disease-specific and global quality of life after tonsillectomy were demonstrated [13].…”

Section: Discussionmentioning

confidence: 99%

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