Twenty-year observational study of paediatric tonsillitis and tonsillectomy

Hulse, Kate; Lindsay, Ewan; Rogers, Alexander; Young, D. R.; Kunanandam, Thushitha; Douglas, Catriona

doi:10.1136/archdischild-2022-323910

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…Tonsillectomy was found to be common among school-going children who were mostly in middle school (57.9%), whereas a study conducted in Australia, by Tran AH et al, showed a high prevalence of tonsillectomy among children 5–9 years of age [ 17 ]. 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 ].…”

Section: Discussionmentioning

confidence: 80%

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

et al. 2023

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The widespread misconception that tonsillectomy leads to a decrease in immunity may lead to fear and avoidance of the operation. This can result in a deterioration of the situation, such as sleep-related breathing issues, frequent infections, and an increase in complications. The current research was conducted to assess the awareness and perception with respect to the impact of tonsillectomy on the immune system and to assess the awareness and perception of the relationship between autoimmune diseases and tonsillectomy. This 6-month descriptive cross-sectional online questionnaire survey was conducted among individuals who were 18 years and above living in Abha city, Saudi Arabia. Out of the 800 study subjects, 104 (13%) had undergone tonsillectomy. Statistically significant associations were found between age group, education, income, and occupation among those who had undergone tonsillectomy. Multivariate logistic regression analysis showed that ages 18–30 years and 31–40 years (OR: 2.36, 95% CI: 1.18–4.71, and OR: 1.46, 95% CI: 0.53–3.97) and education levels of high school, bachelors, and above (OR: 8.30, 95% CI: 3.05–22.58 and OR: 10.89, 95% CI: 4.23–28.05) were found to be associated with tonsillectomy status of the subjects. On the contrary, income levels of 5000–9000 and >9000 (OR: 0.65, 95% CI: 0.36–1.17 and OR: 0.78, 95%CI: 0.42–1.42) and male gender (OR: 0.79, 95% CI: 0.52–1.19) were found to be associated with non-tonsillectomy status of subjects. Almost 36% of study subjects thought that tonsillectomy affects immunity. Only 18% of study subjects thought that there is a relationship between tonsillectomy and autoimmune diseases. About one-third of the respondents had received this information from community members and social media. A small number of study subjects relied on public awareness programs. Therefore, social media can play a vital role in the community to remove misconceptions regarding tonsillectomy and its effect on immunity and autoimmune disease. Further educational interventional studies are required to see the correction to the public perception of tonsillectomy and its effect on immunity and autoimmune diseases.

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Section: Discussionmentioning

confidence: 80%

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

et al. 2023

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“…The worldwide decline of tonsillectomy is associated with more acute admissions for tonsillitis in some countries ( 83 ). There seems to be a correlation between social deprivation and both tonsillectomy and tonsillitis; hence, lower socioeconomic groups are more effected.…”

Section: Discussionmentioning

confidence: 99%

“…The reasons for this appear to be multifactorial. We also might need criteria reflecting the burden of the disease on socioeconomic factors, i.e., beyond the current approach of counting of tonsillitis episodes ( 83 ).…”

Section: Discussionmentioning

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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“…In recent years, the incidence of tonsillitis and enlarged tonsil is increasing with the aggravation of environmental pollution [1]. Besides, passive smoking [2] and infectious agents use [3] may be closely associated with the development of tonsillitis.…”

Section: Introductionmentioning

confidence: 99%

Quality of life in children undergoing tonsillectomy: a cross-sectional survey

2023

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Background The quality of life in children undergoing tonsillectomy remains unclear. We aimed to analyze the current status and influencing factors of quality of life in children undergoing tonsillectomy, to provide useful insights to clinical postoperative care for children. Methods Children who underwent tonsillectomy in our hospital from June 1, 2021 to October 31, 2022 were selected. The characteristics of children were collected and Paediatric Quality of Life Inventory Version 4.0 (PedsQL™ 4.0) was used for evaluating the quality of life in children. Pearson correlation, univariate and logistic regression analyses were condcuted to evaluate the influencing factors of quality of life in children undergoing tonsillectomy. Results A total of 118 children undergoing tonsillectomy were included. The total score of PedsQL™ 4.0 in children undergoing tonsillectomy was (70.28 ± 13.15). Pearson correlation analyses indicated that age(r = 0.586), courses of tonsillitis(r = 0.595), parental education level(r = 0.612) and monthly family income(r = 0.608) were associated with the PedsQL™ 4.0 total score in children undergoing tonsillectomy (all P < 0.05). Logistic regression analyses indicated that age ≤ 5y (OR = 2.009,95%CI: 1.826 ~ 2.401), courses of tonsillitis ≥ 3years (OR = 2.167,95%CI: 1.688 ~ 2.547), high school of parental education level (OR = 1.807,95%CI: 1.224 ~ 2.181) and monthly family income ≤ 5000 RMB(OR = 2.624,95%CI:2.092 ~ 3.077) were the independent influencing factors of quality of life in children with undergoing tonsillectomy (all P < 0.05). Conclusions The quality of life of children after tonsillectomy is not high, and the quality of life of children is affected by many factors. Medical staff should take early targeted nursing countermeasures tageted on those influencing factors to improve the quality of life of children.

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Twenty-year observational study of paediatric tonsillitis and tonsillectomy

Cited by 4 publications

References 24 publications

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

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

Treatment of recurrent acute tonsillitis—a systematic review and clinical practice recommendations

Quality of life in children undergoing tonsillectomy: a cross-sectional survey

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