Evidence note 23: Tonsillectomy for recurrent bacterial tonsillitis (PDF, 212K, 35secs)
Background
Tonsillectomy is surgery to remove the tonsils. It is usually performed as an inpatient procedure under general anaesthetic using cold steel, bipolar diathermy, ultrasound or coblation techniques. Haemostasis is obtained by diathermy alone, both ties and diathermy, ties alone, ultracision or coblation.
The most common indication for tonsillectomy is recurrent bacterial tonsillitis. Other indications which are not the subject of this Evidence Note are cancer, sleep apnoea, quinsy and guttate psoriasis.
Key points
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There is a lack of evidence from wellconducted randomised controlled trials on the clinical effectiveness of tonsillectomy for recurrent bacterial tonsillitis.
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Criteria for tonsillectomy are commonly based on SIGN Guideline 34: sore throats are due to tonsillitis; five or more episodes per year; symptoms for at least a year; episodes prevent normal functioning.
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6% of patients are readmitted with bleeding; 0.2% of patients return to the operating theatre.
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The North of England study of tonsillectomy and adeno-tonsillectomy in children (NESSTAC) is a major randomised controlled trial which is due to report in 2009.