Franzen A M, Jungehülsing M, Berthold U, Rudolf J, Herzog M, Heinze N, Didczuneit-Sandhop B, Kanzock J, Schrom T
Klinik für Hals-Nasen-Ohrenkrankheiten und Plastische Operationen, Medizinische Hochschule Brandenburg, Campus Ruppiner-Kliniken GmbH, Fehrbelliner Straße 38, 16816, Neuruppin, Deutschland.
Klinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum Ernst-von-Bergmann, Potsdam, Deutschland.
HNO. 2019 Aug;67(8):606-611. doi: 10.1007/s00106-019-0670-2.
The frequency of tonsil surgery in Brandenburg (BB) during the period from 2013 to 2017 is analyzed. Causes and possible consequences of the trends are discussed.
An OPS code-based survey is carried out in the 10 ENT hospitals in BB and using the data from the federal states (Federal Statistical Office). In addition, the respective heads of ENT departments are interviewed concerning the indication for tonsillectomy (TE). The average number of operations in 2013/2014 is compared to that in 2017 (BB) and 2016 (federal states).
In 9/10 participating hospitals in BB, 10,302 operations were performed, thereof 58.4% as TE, 19.0% as tonsillotomy (TT), 13.7% as abscess tonsillectomy (abscess TE), and 8.9% other. In BB in 2017 in comparison to 2013/2014, because of the decrease in TE by 45.6%, a total of 21.1% less operations were performed, while TT and abscess TE increased by 32% and 18%, respectively. The average age at surgery was 28.1, 38.1, and 5.9 years for TE, abscess TE, and TT, respectively. The entire trend for Germany until 2016 on the basis of 395,674 cases reflects a decrease in TE (30.7%) and abscess TE (14%), while TT was performed 27.5% more often, resulting in a total decrease of 21.3%. The interviewed persons follow the "justifiable operation indications" of the German guideline from 2015 and adapted their previous practice.
Our survey and results indicate that the massive decrease of TE in BB is associated with the "justifiable operation indications" of the 2015 German guidelines on inflammatory diseases of the tonsils. TE is mainly performed in adults. Therefore, research concerning conservative versus surgical treatment for recurrent tonsillitis is urgently needed for this age profile.
分析2013年至2017年期间勃兰登堡州（BB）扁桃体手术的频率。讨论了趋势的原因及可能的后果。
在BB的10家耳鼻喉医院开展基于手术操作编码的调查，并使用联邦州（联邦统计局）的数据。此外，就扁桃体切除术（TE）的适应症对各耳鼻喉科主任进行访谈。将2013/2014年的平均手术例数与2017年（BB）和2016年（联邦州）的进行比较。
在BB参与调查的10家医院中的9家，共进行了10302例手术，其中TE占58.4%，扁桃体切开术（TT）占19.0%，扁桃体脓肿切除术（脓肿TE）占13.7%，其他占8.9%。与2013/2014年相比，2017年BB的TE减少了45.6%，手术总数减少了21.1%，而TT和脓肿TE分别增加了32%和18%。TE、脓肿TE和TT的平均手术年龄分别为28.1岁、38.1岁和5.9岁。基于395674例病例，德国直至2016年的整体趋势显示TE（30.7%）和脓肿TE（14%）减少，而TT的实施频率增加了27.5%，导致总数减少了21.3%。受访者遵循2015年德国关于扁桃体炎性疾病指南中的“合理手术适应症”，并调整了他们之前的做法。
我们的调查及结果表明，BB地区TE的大幅减少与2015年德国扁桃体炎性疾病指南中的“合理手术适应症”有关。TE主要在成人中进行。因此，针对这一年龄段复发性扁桃体炎的保守治疗与手术治疗的研究亟待开展。
