Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Heidelberg, Ruprecht-Karls-University, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
GESIS-Leibniz-Institute for the Social Sciences, Mannheim, Germany.
Eur Arch Otorhinolaryngol. 2023 Apr;280(4):1963-1971. doi: 10.1007/s00405-022-07758-0. Epub 2022 Nov 28.
Tonsillectomy (TE) for recurrent tonsillitis (RT) is one of the most common surgical interventions. Since 2015, the indication criteria for TE have become much stricter (German S2k guideline). Patient-reported outcome measures (PROMs) of short-term quality of life (QoL) after TE have not yet been investigated.
To clarify if stringent indication for TE will better identify patients worthy of surgery and patients' QoL.
We prospectively studied the Tonsillectomy Outcome Inventory 14 (TOI-14) responses of 38 RT-patients recruited according to the S2k guideline in 2020 and compared their TOI-14 scores with those of a historical RT cohort from 2006 to 2008 and with a healthy middle-European cohort. New RT patients were assessed before, 2, 4, and 14 days and 6 months after TE. TOI-14 was measured as total and as disease-specific score.
From pre- to 6-month postoperative, patients' QoL was significantly different, measured by TOI-14 (49.92 vs. 6.35; p < 0.001) and disease-specific score (60.35 vs. 9.9; p < 0.001). Preoperative disease-specific score was not different from that of the 2nd and 4th postoperative days but from the 14th postoperative day (60.35 vs. 29.26; p < 0.001). The historical cohort had significantly less RT complaints than the new cohort beforehand, but more dissatisfaction in QoL after TE. New TE patients had worse QoL pre- (49.92 vs. 11.78; p < 0.001) but more QoL postoperatively (6.34 vs. 11.78; p = 0.004) than healthy individuals.
Our results show that the tightening of the indication criteria for TE was justified and that TE patients significantly benefit from this surgery from day 14.
扁桃体切除术（TE）治疗复发性扁桃体炎（RT）是最常见的手术干预之一。自 2015 年以来，TE 的适应证标准变得更加严格（德国 S2k 指南）。然而，TE 后短期生活质量（QoL）的患者报告结局测量（PROMs）尚未得到研究。
阐明严格的 TE 适应证是否能更好地识别出值得手术的患者和患者的 QoL。
我们前瞻性研究了 2020 年根据 S2k 指南招募的 38 例 RT 患者的扁桃体切除术后结局量表 14（TOI-14）的反应，并将他们的 TOI-14 评分与 2006 年至 2008 年的历史 RT 队列和健康的中欧队列进行比较。新的 RT 患者在 TE 前、2、4 和 14 天以及 6 个月后进行评估。TOI-14 作为总评分和疾病特异性评分进行测量。
从术前到术后 6 个月，患者的 QoL 有显著差异，TOI-14（49.92 对 6.35；p<0.001）和疾病特异性评分（60.35 对 9.9；p<0.001）均有显著差异。术前疾病特异性评分与术后第 2 天和第 4 天无差异，但与术后第 14 天有差异（60.35 对 29.26；p<0.001）。历史队列在术前比新队列有更少的 RT 抱怨，但 TE 后对 QoL 的不满更多。新 TE 患者术前 QoL 较差（49.92 对 11.78；p<0.001），但术后 QoL 较好（6.34 对 11.78；p=0.004），优于健康个体。
我们的结果表明，TE 适应证标准的收紧是合理的，TE 患者从第 14 天开始就从手术中显著获益。
