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]

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Summary

Introduction

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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