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The purpose of this study is to find out if tonsillectomy reduces the short-term risk of having an objectively confirmed (sequential changes in serum crp and procalcitonin levels) delayed pharyngitis episode among patients suffering from recurrent pharyngitis episodes. Other aims are to find out the effect of tonsillectomy to reduce the number of pharyngitis episodes or symptoms. Still, the possible disadvantages of tonsillectomy and changes in the quality of life after tonsillectomy among these patients are examined.
We will have a prospective randomized study. We allocated 87 consecutive patients referred for tonsillectomy randomly in two groups: tonsilectomy group or waiting list(control group). Patients in tonsillectomy group were operated as soon as possible and data on postoperative morbidity was collected. In the control group, patients were placed on our normal waiting list and they were operated on in normal time (about 5-6 months). The data on preoperative morbidity was collected. All the pharyngitis episodes were treated by a study investigator and laboratory tests (crp, procalcitonin) were taken at that time and after three days. In addition, the patients record their symptoms on a diary.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | No Intervention | patients on waiting list for a minimum of 5 months. These patients receive no prophylactic intervention for their recurrent pharyngitis episodes. |
|
| 2 | Active Comparator | Tonsillectomy as soon as possible after randomization (within 2-3 weeks). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tonsillectomy | Procedure | Tonsillectomy under general anesthesia as a day surgery using diathermy or blunt dissection. Follow up started from the day of surgery. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Absolute percentage difference between groups of patients having pharyngitis with delayed recovery time defined by symptoms and blood sample values (crp, procalcitonin) | 5 months follow up |
| Measure | Description | Time Frame |
|---|---|---|
| Absolute percentage difference of patients having group A streptococcal pharyngitis. | 5 months follow up | |
| Absolute percentage difference of patients having acute pharyngitis episode with and without medical consultation | 5 months follow up |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Petri Koivunen, MD | Dept of Otolaryngology, University of Oulu, Finland | Principal Investigator |
| Aila Kristo, MD | Dept of Otolaryngology, University of Oulu, Finland | Principal Investigator |
| Onni Niemelä | Laboratory, University of Oulu, Finland | Principal Investigator |
| Markku Koskela | Microbiological Laboratory, University of Oulu, Finland | Principal Investigator |
| Timo J Koskenkorva, MD | Dept of Otolaryngology, University of Oulu, Finland | Principal Investigator |
| Olli-Pekka Alho, professor | Dept of Otolaryngology, University of Oulu, Finland | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Oulu University Hospital | Oulu | Finland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23549975 | Derived | Koskenkorva T, Koivunen P, Koskela M, Niemela O, Kristo A, Alho OP. Short-term outcomes of tonsillectomy in adult patients with recurrent pharyngitis: a randomized controlled trial. CMAJ. 2013 May 14;185(8):E331-6. doi: 10.1503/cmaj.121852. Epub 2013 Apr 2. |
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| ID | Term |
|---|---|
| D014069 | Tonsillitis |
| D010612 | Pharyngitis |
| ID | Term |
|---|---|
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D010608 | Pharyngeal Diseases |
| D009057 | Stomatognathic Diseases |
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| ID | Term |
|---|---|
| D014068 | Tonsillectomy |
| ID | Term |
|---|---|
| D013517 | Otorhinolaryngologic Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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| no intervention | Other | No intervention (controls). Follow up started from the day of randomization. |
|
| Difference in the number and quality (mild, severe) of symptomatic days (fever, sore throat, rhinitis, cough) | 5 months follow up |
| Absolute percentage difference having harmful effects related to tonsillectomy (haemorrhage, soft tissue burns etc.) | 5 months follow up |
| D012140 |
| Respiratory Tract Diseases |
| D010038 | Otorhinolaryngologic Diseases |