A Comparative study to evaluate the effectiveness of Tonsillectomy with Long term Penicillin in the management of recurrent tonsillitis

Abstract

Introduction: Tonsillitis is widespread among children and has serious poststreptococcal complications, and both the patients and the otolaryngology surgeon have to face the question on what is the role and benefit of using long-acting penicillin and whether it is an alternative method of treatment to surgery? This study was carried out to evaluate the effectiveness of tonsillectomy compared with long-acting penicillin in the treatment of recurrent tonsillitis, comparing their effects on the levels of the antistreptolysin O titer (ASOT) and erythrocyte sedimentation rate (ESR). Methods: This study was carried out as a prospective study. A total of 100 Children were chosen for this study. Subjects fulfilling the inclusion criteria like , Age of 5–15 years , Children suffering from recurrent tonsillitis with signs of chronic tonsillitis: inequality in the size of the tonsils, enlarged cervical lymph nodes, and pus in the tonsillar crypts 6 , Severe attacks of tonsillitis: seven times in 1 year or five times in each of 2 years, or three times in each of 3 years & An ASOT of greater than 400 IU/ml and an ESR of greater than 30 ml/1 at 1/2 h 10,11.were selected by simple random sampling method. Results : The frequencies of occurrence of fever, cough, obstructive sleep apnea, unequal tonsil size, and pus in the tonsillar crypts were 80% , 51 % , 4% , 52% , and 48 %, respectively. Effect of tonsillectomy versus the effect of long-acting penicillin on ASOT, we found that the levels after 3 months were lower in patients who were treated by tonsillectomy than in those who were treated with long-acting penicillin; the difference between both the groups was found to be statistically significant. Conclusion: This study presents important insight into the alternate treatment regimens of Recurrent Tonsillitis in rural children. This study demonstrates that the first line of treatment of recurrent chronic tonsillitis is tonsillectomy, as it is both clinically effective and cost-effective for children and that the second line of treatment is long-acting penicillin with long-term follow-up, and in patients, have contraindications for surgery such as bleeding diathesis.