Tonsillectomy versus tonsillotomy for recurrent acute tonsillitis in children and adults (TOTO): study protocol for a randomized non-inferiority trial (original) (raw)
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The Cochrane Database of Systematic Reviews, 1999
Analysis 1.1. Comparison 1 Tonsillectomy or adenotonsillectomy versus no surgery in children, Outcome 1 Episodes of sore throat of any severity (including as one episode the period post-surgery) at 12 months.. .. .. .. Analysis 1.2. Comparison 1 Tonsillectomy or adenotonsillectomy versus no surgery in children, Outcome 2 Episodes of moderate/severe sore throat (including as one episode the period post-surgery) at 12 months.. .. .. . Analysis 1.3. Comparison 1 Tonsillectomy or adenotonsillectomy versus no surgery in children, Outcome 3 Sore throat days (including those immediately post-surgery
International journal of pediatric otorhinolaryngology, 2005
To compare the long-term effects (six years after surgery) of two techniques for pediatric tonsil surgery with respect to snoring, apneas, eating difficulties, infections and general health. The two methods were intracapsular partial tonsillectomy (tonsillotomy, "TT") using CO(2)-laser technique and traditional (total) blunt dissection tonsillectomy (TE). A questionnaire distributed by mail to the parents of children, who, in 1998, were included in a prospective clinical randomized study in one tertiary care ENT clinic. A 10 question survey follow-up of 41 children, between 9 and 15 years of age, who originally, six years earlier had been randomized to either TT with CO(2)-laser (n=21) or TE (n=20). The main indication for the surgery was a history of sleep related breathing distress (SRBD). Before the present study, all of the children had participated in earlier follow-ups at six months and one year after surgery. All the children in both groups answered the questionnair...
Journal of Laryngology and Otology, 2014
Objective: To quantify the impact that mild to moderate tonsillitis has on quality of life in children and compare it to that of severe tonsillitis. Methods: In this prospective study, parents of children aged 0-16 years completed the Paediatric Throat Disorders Outcome Test, and quality of life scores in the tonsillitis groups were compared. Results: A hundred children were recruited: 58 had severe tonsillitis and were offered surgery, and 42 had mild to moderate tonsillitis and were managed conservatively. The mean outcome test scores in those children undergoing surgery were 36.7 for tonsillectomy patients and 36.9 for adenotonsillectomy patients, compared with a score of 31.5 for the mild to moderate tonsillitis patients (p = 0.019). Conclusion: Children with mild to moderate disease had significantly better quality of life scores than those with severe disease. It is thought that those with mild to moderate disease have short-term improvements in general quality of life after surgery, which disappear in the medium term. This transient improvement needs to be balanced against the morbidity of the surgery and the cost burden to the National Health Service. The results of this study support the national drive towards limiting tonsillectomy to children with severe tonsillitis or obstructive sleep apnoea.
Trials, 2015
The role of tonsillectomy in the management of adult tonsillitis remains uncertain and UK regional variation in tonsillectomy rates persists. Patients, doctors and health policy makers wish to know the costs and benefits of tonsillectomy against conservative management and whether therapy can be better targeted to maximise benefits and minimise risks of surgery, hence maximising cost-effective use of resources. NATTINA incorporates the first attempt to map current NHS referral criteria against other metrics of tonsil disease severity. A UK multi-centre, randomised, controlled trial for adults with recurrent tonsillitis to compare the clinical and cost-effectiveness of tonsillectomy versus conservative management. An initial feasibility study comprises qualitative interviews to investigate the practicality of the protocol, including willingness to randomise and be randomised. Approximately 20 otolaryngology staff, 10 GPs and 15 ENT patients will be recruited over 5 months in all 9 pr...
Can Intracapsular Tonsillectomy Be an Alternative to Classical Tonsillectomy? A Meta-analysis
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2017
Objective Tonsillectomy is the most common operation performed in the otolaryngologic fields. Efforts have been made to reduce postoperative complications, and one of these is intracapsular tonsillectomy and adenoidectomy (ICTA), which leaves the tonsillar tissue with tonsillar capsule. This study aimed to evaluate intracapsular tonsillectomy compared with classical extracapsular tonsillectomy in terms of efficacy of the technique for managing obstructive sleep apnea (OSA) and reducing postoperative complications. Data Sources We performed a literature search using PubMed, EMBASE, and the Cochrane Library through December 2016. Review Methods Summarized risk ratio (RR), risk differences (RDs), and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were estimated by summarizing the risk estimates of each study using random-effects models that considered both within- and between-study variations. Results Our search included 15 randomized controlled studies. The R...
Analysing the Role of Tonsillectomy in Recurrent Tonsillitis: A Combined Study
International Journal of Innovative Science and Research TechnologyVolume 8, Issue 6, June 2023, 2023
The aim of this study was to examine the effects of tonsillectomy on the frequency of episodes, pain scores, and quality of life in individuals who suffered from recurrent tonsillitis. Additionally, this research sought to explore the potential influence of patient characteristics on the aforementioned outcomes. Methods: Over a period of three years, a combined retrospective &prospective study was carried out on a cohort of 200 patients aged between 5 and 50 years who had undergone tonsillectomy due to recurrent tonsillitis. The frequency of tonsillitis episodes, pain scores, and quality of life were assessed pre-and post-operatively. The study investigated postoperative complications and their correlation with patient characteristics in determining outcomes. Results: Following a tonsillectomy procedure, a noteworthy reduction was noted in the frequency of tonsillitis occurrences, with an average decrease from 8 to 1 per annum. Additionally, pain scores decreased significantly from 7.5 to 1.5 out of 10, and there was a marked improvement in quality-of-life scores, with an increase from 48 to 88 out of 100. The influence of age on outcomes was found to be significant, with younger patients exhibiting superior results. A small proportion of patients experienced postoperative complications. Conclusion: The surgical procedure of tonsillectomy has been observed to have a substantial impact on the reduction of the frequency of tonsillitis episodes, as well as the alleviation of pain scores and enhancement of the quality of life in patients who experience recurrent tonsillitis. The results of this study provide evidence for the efficacy of tonsillectomy as a means of managing recurrent tonsillitis. This may have implications for clinical decision-making and health policy. Additional investigation is required to examine prolonged consequences and supplementary determinants.
International Journal of Pediatric Otorhinolaryngology, 2005
This report is a preliminary exploration of the concept of a ''Tonsillectomy Index'' (TI) as an objective tool for quantifying the indications for tonsillectomy for recurrent acute tonsillitis (AT). The TI is derived by multiplying the number of episodes of AT by the number of years during which the episodes of AT occurred. Our objective in this study was to investigate whether there is a relationship between the natural history of AT, the immunological functions of tonsils and our proposed TI.
Pediatric tonsillectomy: clinical practice guidelines
European annals of otorhinolaryngology, head and neck diseases, 2012
This article presents the Clinical Practice Guidelines for Pediatric Tonsillectomy of the French Society of ENT and Head and Neck Surgery (SFORL), entitled "Amygdalectomie de l'enfant : Recommandation pour la pratique clinique" (SFORL, 2009). The French Society of ENT (SFORL), in partnership with the French Association for Ambulatory Surgery (AFCA) and French Society for Anaesthesia and Intensive Care (SFAR), set up a representative panel in the fields of anesthesiology, ENT and head-and-neck surgery, pediatrics, sleep medicine and general medicine. Following the literature analysis reported in the Presentation of the Guidelines, recommendations were drawn up taking account of risk/benefit ratios, levels of evidence, feasibility in pediatric tonsillectomy and baseline risk assessment in the relevant population. Around 50,000 pediatric tonsillectomies, with or without associated adenoidectomy, are performed in France each year. Postoperative morbidity and mortality are ...