Abstract
ObjectivesThe objective of this study was to compare post-operative visits for upper respiratory infections (URIs) between tonsillectomy and non-tonsillectomy participants (controls).MethodsUsing the national cohort study from the Korean Health Insurance Review and Assessment Service, 1:4 matched (age, sex, income, region, and pre-operative URI visit) tonsillectomy participants (5,831) and control participants (23,324) were selected. Post-operative visits for URI were measured from 1 to 9 years post-op. The equivalence test was used. The margin of equivalence of the difference (Tonsillectomy—Control group group) was set to -0.5 to 0.5.ResultsThere was no difference between the tonsillectomy and control group in 1- to 9-year post-op visits (-0.5 < 95% CI of difference < 0.5). URI visits gradually decreased from 5.5/2 years (pre-op) to 2.1/year (at 1 year post-op) and 1.4/year (at 9 years post-op) in both tonsillectomy and control groups. In the subgroup analysis (children Vs adolescent and adults; rare Vs frequent pre-operative URI), there was no difference in the number of post-op visits for URI between the tonsillectomy and control groups (-0.5 < 95% CI of difference < 0.5).ConclusionTonsillectomy does not provide a decrease in the number of post-operative visits for URI, and URI decreased over time whether or not a tonsillectomy was performed.
Highlights
Tonsillectomy with/without adenoidectomy is one of the most commonly performed surgeries, especially in children [1,2,3]
upper respiratory infection (URI) visits gradually decreased from 5.5/2 years to 2.1/year and 1.4/year in both tonsillectomy and control groups
In the subgroup analysis, there was no difference in the number of post-op visits for URI between the tonsillectomy and control groups (-0.5 < 95% confidence interval (CI) of difference < 0.5)
Summary
Tonsillectomy with/without adenoidectomy is one of the most commonly performed surgeries, especially in children [1,2,3]. The reported rate of tonsillectomy in children and adolescents is 7.9 per 1,000 in the US [4] and 2.6 per 1,000 in Korea [3]. Tonsillectomy is generally performed for recurrent sore throat or obstructive sleep apnea (OSA) [5, 6]. Paradise et al reported the “paradise criteria" for tonsillectomy in recurrent tonsillitis [2, 8], the evidence for its clinical efficacy is limited [9]. Even with the current lack of robust clinical evidence, infection (23.2%) remains one of the most common reasons for performing a tonsillectomy [12]
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