Tonsillectomy benefits adults with recurrent pharyngitis
medwireNews: Adults who experience recurrent pharyngitis may benefit from having their tonsils removed, report researchers.
Of the 86 patients in the study who suffered from severe pharyngitis more than three times per year, those who had undergone tonsillectomy experienced fewer episodes of pharyngitis and less frequent throat pain than individuals who chose not to undergo the procedure.
"These reductions resulted in fewer medical visits and fewer absences from school or work," report Timo Koskenkorva (Oulu University Hospital, Finland) and team.
Currently, there is limited evidence of the benefit of tonsillectomy in adults, says the team. Although a recent Cochrane review on tonsillectomy for recurrent tonsillitis showed that the procedure reduces the frequency of sore throats in children, only one trial included adults.
As reported in the Canadian Medical Association Journal, Koskenkorva and colleagues conducted a randomized, controlled trial including patients aged a mean of 26.5 years who were referred for tonsillectomy due to recurring pharyngitis (>3 episodes within the previous 12 months), between October 2007 and December 2010.
The patients were randomly allocated to be placed on a waiting list for tonsillectomy within 5 or 6 months (controls; n=40), or to undergo tonsillectomy as soon as possible (n=46).
The researchers report that after 5 months of follow up, there was no significant between-group difference in the number of individuals who experienced an episode of severe pharyngitis, as defined by a C-reactive protein level of over 40 mg/dL, and the presence of edema, erythema, or exudative tonsillitis.
However, only two (4%) tonsillectomy patients had consulted a physician for pharyngitis (sore throat lasting 2 days or more) while a significantly greater proportion of the controls had consulted a physician for the same reason, at 17 (43%). In addition, only 18 (39%) tonsillectomy patients experienced acute pharyngitis, as defined by the symptoms of throat pain, rhinitis, fever, as well as absence from school or work, compared with 32 (80%) controls.
Furthermore, the number of absences from work or school was significantly lower in the tonsillectomy versus control group, at means of 3.3 versus 6.6 days.
The researchers point out that although they found a clear benefit of tonsillectomy among the patients studied, the pharyngitis and sore throats that were prevented by surgery were mild and probably of viral origin.
"The morbidity and complications related to tonsillectomy must be considered when physicians and patients decide whether the clinical benefits outweigh the risks of surgery," they warn.
medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013
By Sally Robertson, medwireNews Reporter