Indication for tonsillectomy – Has the new guideline of 2015 influenced the indication habits of physicians?

Background In 2015, the German guideline “Therapy of inflammatory diseases of the tonsils/tonsillitis” was published. Objectives. The objective of this study was to analyze the influence of the guideline on the indication for tonsillectomy/tonsillotomy. The indications for these operations were considered, and whether they had changed after the publication of the guideline. These analyzes were carried out based on the patients‘ age.

Materials and methods 2 samples of 300 patients each (n total = 600) who received a tonsillectomy or a tonsillotomy (possibly in combination with other procedures) at the University Hospital Magdeburg in 2014 and 2016 were analyzed.

Results The guideline had no influence on the indication for tonsillectomy. Adherence to the guidelines was more frequent in patients over 30 years of age than in other age groups. Indications other than chronic tonsillitis are of great importance: 72.2% (2014) and 67.3% (2016) of patients presented with at least one other indication in addition to chronic tonsillitis. Chronic tonsillitis was diagnosed significantly more often in 15-30 year olds, other indications were significantly more common in 0-5 year olds.

Discussion The study highlights the importance of indications other than chronic tonsillitis, particularly in children under 6 years of age. Further studies are necessary to present evidence on further indications for tonsillectomy and tonsillotomy and to offer specific recommendations for physicians in this regard. The indication should always be checked and clearly documented prior to tonsillar surgery. The guideline should cover further indications.

Publication History

Article published online:
12 May 2023