Abstract
The literature lacks data about the evaluation of throat-related symptoms proving chronic tonsillitis as the most common indication for adult tonsillectomy. Therefore, the aim of this study was to assess the most important throat-related symptoms suggestive of chronic tonsillitis in adults. A prospective cohort study was carried out. The analysis of throat-related symptoms (complaints, tonsillitis rate, pharyngeal signs, and antistreptolysin-O titer) in 81 adults with histologically confirmed chronic tonsillitis was conducted. Recurrent tonsillitis was the most common complaint (74.1%). The mean number of tonsillitis episodes was 3.6 (SD, 1.9) times per year. There were no significant differences comparing the frequencies of all the analyzed pharyngeal signs (P>0.05). The antistreptolysin-O titer (mean, 279.8; SD, 211.6 UL) was pathological in 33.3% of patients. The study identified the most important throat-related symptoms revealing chronic tonsillitis: tonsillar cryptic debris (OR, 8.84; 95% CI, 1.93-40.53; P=0.005) and enlarged anterior cervical lymph nodes along with the frequency of tonsillitis episodes exceeding 3 times per year (OR, 8.27; 95% CI, 1.33-51.57; P=0.024). The classification accuracy of 85.2% was obtained. Tonsillar cryptic debris and enlarged regional lymph nodes along with recurrent tonsillitis could support the diagnosis of chronic tonsillitis in adults when considering tonsillectomy.
Highlights
According to the last 25-year literature, chronic or recurrent tonsillitis is the most common indication for adult tonsillectomy (TE) [1, 2]
Tonsillar cryptic debris and enlarged regional lymph nodes along with recurrent tonsillitis could support the diagnosis of chronic tonsillitis in adults when considering tonsillectomy
Some recent randomized controlled studies involving adults with chronic tonsillitis have demonstrated a significant improvement in quality of life after TE: a decrease in the frequency of episodes of chronic or recurrent sore throat, group A streptococcal (GABS) pharyngitis, and missed workdays as well as a reduction in antibiotic use [3,4,5,6,7,8]
Summary
According to the last 25-year literature, chronic or recurrent tonsillitis is the most common indication for adult tonsillectomy (TE) [1, 2]. Some recent randomized controlled studies involving adults with chronic tonsillitis have demonstrated a significant improvement in quality of life after TE: a decrease in the frequency of episodes of chronic or recurrent sore throat, group A streptococcal (GABS) pharyngitis, and missed workdays as well as a reduction in antibiotic use [3,4,5,6,7,8]. The benefit of TE is confirmed by long-term follow-up data : more than 87% of patients would recommend surgery for chronic tonsillitis [8, 9].
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