Evidence note 23
Tonsillectomy for recurrent bacterial tonsillitis
Background
Tonsillectomy is surgery to remove the
tonsils. It is usually performed as an inpatient procedure under
general anaesthetic using cold steel, bipolar diathermy, ultrasound
or coblation techniques. Haemostasis is obtained by diathermy
alone, both ties and diathermy, ties alone, ultracision or
coblation.
The most common indication for
tonsillectomy is recurrent bacterial tonsillitis. Other indications
which are not the subject of this Evidence Note are cancer, sleep
apnoea, quinsy and guttate psoriasis.
Key points
- There is a lack of evidence from wellconducted randomised
controlled trials on the clinical effectiveness of tonsillectomy
for recurrent bacterial tonsillitis.
- Criteria for tonsillectomy are commonly based on SIGN Guideline
34: sore throats are due to tonsillitis; five or more episodes per
year; symptoms for at least a year; episodes prevent normal
functioning.
- 6% of patients are readmitted with bleeding; 0.2% of patients
return to the operating theatre.
- The North of England study of tonsillectomy and
adeno-tonsillectomy in children (NESSTAC) is a major randomised
controlled trial which is due to report in 2009.
Published Date: 1 May 2008
