Total versus subtotal tonsillectomy for recurrent tonsillitis – a prospective randomized noninferiority clinical trial

Abstract

Background: For many years experts have called for randomized controlled trials to resolve the question whether tonsillectomy, which is associated with significant comorbidity, can be replaced by partial tonsillectomy in patients with recurrent tonsillitis.

Objective: To find out whether subtotal tonsillectomy is a suitable therapeutic alternative to total tonsillectomy in adult patients with recurrent episodes of acute tonsillitis.

Material and methods: Study design – Single-blind prospective non-inferiority randomized clinical trial with intraindividual design. Setting – 80 patients were recruited at a tertiary referral center. Subjects – Adult patients with recurrent tonsillitis received total tonsillectomy on one side and subtotal tonsillectomy on the other side after randomization. Main outcome measure was frequency of postoperative tonsillitis on the side of subtotal tonsillectomy and postoperative pharyngitis in the former tonsil area on the side of total tonsillectomy. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00015628).

Results: Within 12 months none of the subjects suffered from recurrent tonsillitis after subtotal tonsillectomy. Subtotal tonsillectomy caused less pain than total tonsillectomy.

Conclusion: Subtotal tonsillectomy might be an alternative treatment option associated with lower morbidity than total tonsillectomy in adults with recurrent tonsillitis.

Chinese abstract

背景：多年来, 专家们呼吁进行随机对照试验, 以解决复发性扁桃体炎患者的扁桃体切除术是否可以被部分扁桃体切除术所取代的问题。

目的：探讨对于成人急性扁桃体炎复发患者来说, 次全扁桃体切除术是否是全扁桃体切除术的合适替代疗法。

材料与方法：研究设计---单盲前瞻性非劣效性随机临床试验, 个体设计。情境---在三级转诊中心招募了80名患者。受试者---随机分组后, 成人复发性扁桃体炎患者一侧接受全扁桃体切除术, 另一侧接受次全扁桃体切除术。主要观察指标为次全扁桃体切除侧术后扁桃体炎发生率和全扁桃体切除侧术后原扁桃体区咽炎发生率。该研究已在德国临床试验注册处注册（DRKS-ID:DRKS00015628）。

结果：12个月内无一例扁桃体切除术后复发。次全扁桃体切除术比全扁桃体切除术引起的疼痛少。

结论：对成人复发性扁桃体炎患者来说, 次全扁桃体切除术可能是一种比全扁桃体切除术有更低发病率的治疗方法。

Keywords:

• Tonsillitis
• tonsillectomy
• tonsillotomy

Disclosure statement

No potential conflict of interest was reported by the author(s).