Quality of Life After Tonsillectomy in Adult Patients with Recurrent Acute Tonsillitis: a Systematic Review

Overview

Journal Eur Arch Otorhinolaryngol

Specialty Otorhinolaryngology

Date 2022 Jan 19

PMID 35044507

Authors

Hannah Inez Houborg

Tejs Ehlers Klug

Affiliations

Soon will be listed here.

Abstract

Purpose: The aims of this systematic review were to (1) explore the evidence for improved quality of life (QOL) in adult patients undergoing tonsillectomy because of recurrent acute tonsillitis (RT) and (2) evaluate which set of guidelines for tonsillectomy in adult RT patients is preferable, using QOL as outcome measure.

Methods: A systematic search was conducted in the PubMed, Embase, and Scopus databases. RCT/cohort studies exploring the effect of elective tonsillectomy in adult RT patients using any QOL assessment tool no less than 6 months after surgery were included. Studies were divided into two guideline groups based on the number of tonsillitis episodes required for tonsillectomy (Group 1: ≥ 5; Group 2: ≤ 4).

Results: A total of 364 unique records were identified. Seven studies (n = 409 patients) were included in a qualitative analysis and four studies were included in a meta-analysis. Patients' QOL rose significantly, primarily because of improvements in the general and physical domains. In the meta-analysis, 96% (293/304) of patients benefitted from tonsillectomy. Patients included in guideline Group 1 studies had significantly higher QOL scores (Glasgow Benefit Inventory (GBI) 39.6) compared to patients in Group 2 studies (GBI 24.9) (p < 0.001).

Conclusion: Adult patients undergoing tonsillectomy because of RT reported improved QOL 6-84 months after surgery. The benefit of tonsillectomy was higher among patients in studies with a higher minimum number of tonsillitis episodes compared to those included in studies with less strict criteria. Whether the improved QOL outweigh the morbidity associated with surgery in both guideline groups remains unclear.

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References

Galindo Torres B, De Miguel Garcia F, Whyte Orozco J . Tonsillectomy in adults: Analysis of indications and complications. Auris Nasus Larynx. 2017; 45(3):517-521. DOI: 10.1016/j.anl.2017.08.012. View

Laing M, McKerrow W . Adult tonsillectomy. Clin Otolaryngol Allied Sci. 1991; 16(1):21-4. DOI: 10.1111/j.1365-2273.1991.tb01936.x. View

Mui S, Rasgon B, Hilsinger Jr R . Efficacy of tonsillectomy for recurrent throat infection in adults. Laryngoscope. 1998; 108(9):1325-8. DOI: 10.1097/00005537-199809000-00012. View

Bhattacharyya N, Kepnes L . Economic benefit of tonsillectomy in adults with chronic tonsillitis. Ann Otol Rhinol Laryngol. 2002; 111(11):983-8. DOI: 10.1177/000348940211101106. View

Baumann I, Kucheida H, Blumenstock G, Zalaman I, Maassen M, Plinkert P . Benefit from tonsillectomy in adult patients with chronic tonsillitis. Eur Arch Otorhinolaryngol. 2006; 263(6):556-9. DOI: 10.1007/s00405-006-0009-y. View

Richards A, Bailey M, Hooper R, Thomson P . Quality-of-life effect of tonsillectomy in a young adult group. ANZ J Surg. 2007; 77(11):988-90. DOI: 10.1111/j.1445-2197.2007.04296.x. View

Schwentner I, Hofer S, Schmutzhard J, Deibl M, Sprinzl G . Impact of tonsillectomy on quality of life in adults with chronic tonsillitis. Swiss Med Wkly. 2007; 137(31-32):454-61. DOI: 10.4414/smw.2007.11735. View

Witsell D, Orvidas L, Stewart M, Hannley M, Weaver E, Yueh B . Quality of life after tonsillectomy in adults with recurrent or chronic tonsillitis. Otolaryngol Head Neck Surg. 2008; 138(1 Suppl):S1-8. DOI: 10.1016/j.otohns.2007.08.015. View

Akgun D, Seymour F, Qayyum A, Crystal R, Frosh A . Assessment of clinical improvement and quality of life before and after tonsillectomy. J Laryngol Otol. 2008; 123(2):199-202. DOI: 10.1017/S0022215108002600. View

10.

Wireklint S, Ericsson E . Health-related quality of life after tonsillotomy versus tonsillectomy in young adults: 6 years postsurgery follow-up. Eur Arch Otorhinolaryngol. 2012; 269(8):1951-8. DOI: 10.1007/s00405-012-1990-y. View

11.

Andreou N, Hadjisymeou S, Panesar J . Does tonsillectomy improve quality of life in adults? A systematic literature review. J Laryngol Otol. 2013; 127(4):332-8. DOI: 10.1017/S0022215113000273. View

12.

Ovesen T, Kamarauskas A, Hlidarsdottir T, Dahl M, Mainz J . Good long-term results after tonsillectomy in ear, nose and throat practices. Dan Med J. 2013; 60(5):A4637. View

13.

Wiksten J, Blomgren K, Roine R, Sintonen H, Pitkaranta A . Effect of tonsillectomy on health-related quality of life and costs. Acta Otolaryngol. 2013; 133(5):499-503. DOI: 10.3109/00016489.2012.728716. View

14.

Tzelnick S, Hilly O, Vinker S, Bachar G, Mizrachi A . Long-term outcomes of tonsillectomy for recurrent tonsillitis in adults. Laryngoscope. 2019; 130(2):328-331. DOI: 10.1002/lary.27928. View

15.

Seethaler A, Rudack C, Spiekermann C . Structured literature review of patient-reported outcome (PRO) instruments in adult tonsillectomy or tonsillotomy. Health Qual Life Outcomes. 2019; 17(1):122. PMC: 6631536. DOI: 10.1186/s12955-019-1192-z. View

16.

Skevas T, Klingmann C, Plinkert P, Baumann I . [Development and validation of the Tonsillectomy Outcome Inventory 14]. HNO. 2012; 60(9):801-6. DOI: 10.1007/s00106-012-2545-7. View

17.

Steinbichler T, Bender B, Blassnigg E, Riechelmann H . Evaluation of a German version of the tonsil and adenoid health status instrument. J Otolaryngol Head Neck Surg. 2014; 43:41. PMC: 4232686. DOI: 10.1186/s40463-014-0041-7. View

18.

Roplekar R, Van M, Hussain S . Does the quality of life impact of tonsillitis correlate with SIGN guideline compliance? An assessment of range and normality. Clin Otolaryngol. 2015; 41(5):481-6. DOI: 10.1111/coa.12573. View

19.

Laajala A, Autio T, Ohtonen P, Alho O, Koskenkorva T . Interpretation of Tonsillectomy Outcome Inventory-14 scores: a prospective matched cohort study. Eur Arch Otorhinolaryngol. 2020; 277(5):1499-1505. PMC: 7160096. DOI: 10.1007/s00405-020-05832-z. View

20.

Plath M, Sand M, Federspil P, Plinkert P, Baumann I, Zaoui K . Normative tonsillectomy outcome inventory 14 values as a decision-making tool for tonsillectomy. Eur Arch Otorhinolaryngol. 2020; 278(5):1645-1651. PMC: 8057992. DOI: 10.1007/s00405-020-06374-0. View