title: Short-term outcomes of tonsillectomy in adult patients with recurrent pharyngitis: a randomized controlled trial.
abstract: BACKGROUND
  Limited evidence exists as to the benefit of tonsillectomy in adult patients. We sought to determine the short-term efficacy of tonsillectomy for recurrent pharyngitis in adults.
  
  
  METHODS
  We conducted a randomized, controlled, parallel-group trial at a tertiary care ear, throat and nose centre in Oulu, Finland, between October 2007 and December 2010. Adult patients with recurrent pharyngitis were randomly assigned to the control group (watchful waiting) or the tonsillectomy group. Our primary outcome was the difference in the proportion of patients with severe pharyngitis (severe symptoms and C-reactive protein level > 40 mg/L) within 5 months. Our secondary outcomes included differences between groups in proportions of patients who had episodes of pharyngitis with or without medical consultation, rates of pharyngitis and numbers of days with symptoms.
  
  
  RESULTS
  Of 260 patients referred for tonsillectomy because of recurrent pharyngitis, we recruited 86 participants for our study. Of these, 40 patients were randomly allocated to the control group, and 46 were randomly allocated to the tonsillectomy group. One patient in the control group and no patients in the tonsillectomy group had a severe episode of pharyngitis (difference 3%, 95% confidence interval [CI] -2% to 7%). Seventeen patients in the control group (43%) and 2 patients in the tonsillectomy group (4%) consulted a physician for pharyngitis (difference 38%, 95% CI 22% to 55%). Overall, 32 patients in the control group (80%) and 18 patients in the tonsillectomy group (39%) had an episode of pharyngitis during the 5-month follow-up (difference 41%, 95% CI 22% to 60%). The rate of pharyngitis and number of symptomatic days were significantly lower in the tonsillectomy group than in the control group.
  
  
  CONCLUSIONS
  There was no significant difference in the number of episodes of severe pharyngitis between the control and treatment groups, and episodes were rare. However, tonsillectomy resulted in fewer symptoms of pharyngitis, consequently decreasing the number of medical visits and days absent from school or work. For this reason, surgery may benefit some patients.
  
  
  BACKGROUND
  ClinicalTrials.gov, no. NCT00547391.
authors.affiliation: Department of Otorhinolaryngology, Institute of Clinical Medicine, University of Oulu and Oulu University Hospital, Oulu, Finland. timo.koskenkorva@ppshp.fi
authors.forename: Timo
authors.initials: T
authors.lastname: Koskenkorva
authors.forename: Petri
authors.initials: P
authors.lastname: Koivunen
authors.forename: Markku
authors.initials: M
authors.lastname: Koskela
authors.forename: Onni
authors.initials: O
authors.lastname: Niemela
authors.forename: Aila
authors.initials: A
authors.lastname: Kristo
authors.forename: Olli-Pekka
authors.initials: OP
authors.lastname: Alho
mesh_terms: D000328:Adult; D002097:C-Reactive Protein; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010612:Pharyngitis / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D012008:Recurrence; D014068:Tonsillectomy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein
references.citation: Arch Dis Child. 2005 Jan;90(1):19-25
references.pmid: 15613505
references.citation: Otolaryngol Head Neck Surg. 1998 Jan;118(1):61-8
references.pmid: 9450830
references.citation: Value Health. 2005 Mar-Apr;8(2):94-104
references.pmid: 15804318
references.citation: Arch Otolaryngol Head Neck Surg. 2001 Nov;127(11):1347-50
references.pmid: 11701072
references.citation: BMJ. 2007 May 5;334(7600):939
references.pmid: 17347187
references.citation: Arch Otolaryngol Head Neck Surg. 2001 Jan;127(1):37-44
references.pmid: 11177012
references.citation: ANZ J Surg. 2007 Nov;77(11):988-90
references.pmid: 17931263
references.citation: Cochrane Database Syst Rev. 2000;(2):CD001802
references.pmid: 10796824
references.citation: Clin Infect Dis. 2002 Jul 15;35(2):113-25
references.pmid: 12087516
references.citation: J Laryngol Otol. 2009 Sep;123(9):1010-4
references.pmid: 19389265
references.citation: BMJ. 2007 May 19;334(7602):1019
references.pmid: 17510113
references.citation: Eur Arch Otorhinolaryngol. 2006 Jun;263(6):556-9
references.pmid: 16491389
references.citation: Dtsch Arztebl Int. 2010 Sep;107(36):622-8
references.pmid: 20948776
references.citation: Emerg Med J. 2011 Aug;28(8):715-7
references.pmid: 21788241
references.citation: Ann Otol Rhinol Laryngol. 2002 Nov;111(11):983-8
references.pmid: 12450171
references.citation: Ann Otol Rhinol Laryngol. 1996 Jun;105(6):415-22
references.pmid: 8638891