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全扁桃体切除术或部分扁桃体切除术(扁桃体切除术或扁桃体切开术)对复发性或慢性扁桃体炎成人生活质量的影响:一项随机对照试验的研究方案

Total or partial tonsillar resection (tonsillectomy or tonsillotomy) to change the quality of life for adults with recurrent or chronic tonsillitis: study protocol for a randomised controlled trial.

作者信息

Laajala Aleksi, Tokola Paulus, Autio Timo J, Koskenkorva Timo, Tastula Mikko, Ohtonen Pasi, Läärä Esa, Alho Olli-Pekka

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, P.O. Box 5000, FIN-90014, Oulu, Finland.

PEDEGO Research Unit, University of Oulu, Oulu, Finland.

出版信息

Trials. 2021 Sep 15;22(1):617. doi: 10.1186/s13063-021-05539-4.

Abstract

BACKGROUND

Tonsillar surgery has been used for decades to treat recurrent and chronic tonsillitis in adults. Recurrent and chronic tonsillitis result in disturbing symptoms, treatment costs, sick leave, and impaired quality of life (QoL). Theoretically, removing all or part of the altered pathological palatal lymphoid tissue alleviates the symptoms and enhances the QoL. Whether this is true with total or partial tonsillar resection (tonsillectomy (TE) and tonsillotomy (TT), respectively) has not been reported in a randomised trial yet.

METHODS

We conduct a multicentre, partly blinded, randomised, 6-month, parallel-group clinical study including 285 adult participants referred to surgical treatment for chronic or recurrent tonsillitis. The participants will either have TE, TT or watchful waiting (WW). The primary outcome will be the difference between the mean disease-specific Tonsillectomy Outcome Inventory-14 (QoL questionnaire) scores at 6 months. Comparison is made firstly between the combined TE+TT and WW groups (superiority analysis), and secondly between the TE and TT groups (non-inferiority analysis).

DISCUSSION

This study will add significant new information to the effects and harms of TE and TT procedures in the treatment of adults with chronic or recurrent tonsillitis.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT04657549.

摘要

背景

扁桃体手术已被用于治疗成人复发性和慢性扁桃体炎数十年。复发性和慢性扁桃体炎会导致令人困扰的症状、治疗费用、病假以及生活质量(QoL)受损。理论上,切除全部或部分发生改变的病理性腭部淋巴组织可缓解症状并提高生活质量。然而,在一项随机试验中,全扁桃体切除术(TE)或部分扁桃体切除术(TT,分别对应扁桃体切除和扁桃体切开术)是否真的如此,尚未见报道。

方法

我们开展了一项多中心、部分盲法、随机、为期6个月的平行组临床研究,纳入285名因慢性或复发性扁桃体炎而接受手术治疗的成年参与者。参与者将接受TE、TT或观察等待(WW)。主要结局将是6个月时疾病特异性扁桃体切除术后结果量表-14(生活质量问卷)平均得分之间的差异。首先在TE+TT联合组与WW组之间进行比较(优效性分析),其次在TE组和TT组之间进行比较(非劣效性分析)。

讨论

本研究将为TE和TT手术治疗成人慢性或复发性扁桃体炎的效果和危害增添重要的新信息。

试验注册

ClinicalTrials.gov:NCT04657549。

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