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Does a tonsillectomy indicated according to the German S2k guideline affect short-term quality of life in adults?

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Abstract

Background

Tonsillectomy (TE) for recurrent tonsillitis (RT) is one of the most common surgical interventions. Since 2015, the indication criteria for TE have become much stricter (German S2k guideline). Patient-reported outcome measures (PROMs) of short-term quality of life (QoL) after TE have not yet been investigated.

Purpose

To clarify if stringent indication for TE will better identify patients worthy of surgery and patients’ QoL.

Methods

We prospectively studied the Tonsillectomy Outcome Inventory 14 (TOI-14) responses of 38 RT-patients recruited according to the S2k guideline in 2020 and compared their TOI-14 scores with those of a historical RT cohort from 2006 to 2008 and with a healthy middle-European cohort. New RT patients were assessed before, 2, 4, and 14 days and 6 months after TE. TOI-14 was measured as total and as disease-specific score.

Results

From pre- to 6-month postoperative, patients’ QoL was significantly different, measured by TOI-14 (49.92 vs. 6.35; p < 0.001) and disease-specific score (60.35 vs. 9.9; p < 0.001). Preoperative disease-specific score was not different from that of the 2nd and 4th postoperative days but from the 14th postoperative day (60.35 vs. 29.26; p < 0.001). The historical cohort had significantly less RT complaints than the new cohort beforehand, but more dissatisfaction in QoL after TE. New TE patients had worse QoL pre- (49.92 vs. 11.78; p < 0.001) but more QoL postoperatively (6.34 vs. 11.78; p = 0.004) than healthy individuals.

Conclusions

Our results show that the tightening of the indication criteria for TE was justified and that TE patients significantly benefit from this surgery from day 14.

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Availability of data and material

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

No external/additional funding was received for this study.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Heidelberg, Ruprecht-Karls-University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany

    Michaela Plath, Kjell Behnen, Karim Plath & Ingo Baumann

  2. GESIS-Leibniz-Institute for the Social Sciences, Mannheim, Germany

    Matthias Sand

Authors
  1. Michaela Plath
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  2. Matthias Sand
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  4. Karim Plath
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  5. Ingo Baumann
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Contributions

All authors made substantial contributions to the study. MP: designed and coordinated the study, participated in data acquisition and analysis, interpreted the data, and drafted the manuscript. MS: participated in data interpretation and statistical analysis. KB: coordinated the study. KP: coordinated the study and revised the manuscript. IB: designed the study and critically revised the manuscript for important intellectual content.

Corresponding author

Correspondence to Michaela Plath.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

The ethics committee of the Medical Faculty at the University of Heidelberg granted permission to conduct the study No.: S-169/2020 and No.: 363/2005. The study was performed according to the Declaration of Helsinki on biomedical research involving human subjects. All patients were informed about the study aims and protocol, and participants were enrolled after giving informed written consent.

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Informed consent was obtained from all individual participants included in the study.

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Plath, M., Sand, M., Behnen, K. et al. Does a tonsillectomy indicated according to the German S2k guideline affect short-term quality of life in adults?. Eur Arch Otorhinolaryngol 280, 1963–1971 (2023). https://doi.org/10.1007/s00405-022-07758-0

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  • DOI: https://doi.org/10.1007/s00405-022-07758-0

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