(Press-News.org)
Scientists say tonsil removal is both clinically and cost effective for adults who get recurrent severe sore throats.
The biggest study of its kind, carried out by Newcastle University, revealed that patients who had a tonsillectomy had 50% less sore throats over two years, compared to patients who did not undergo tonsillectomy. Publishing today (17 May) in The Lancet, the study was funded by the National Institute for Health and Care Research (NIHR).
Experts also found that a tonsillectomy for those aged 16 years and over was cost effective in comparison to treatment with painkillers and ad hoc antibiotics.
Tonsillectomy assurance
A tonsillectomy, cutting out the two lumps of lymphoid tissue found at either side of the back of the throat, is an operation that has been widely used to improve the quality of life for patients.
However, in recent years, less adult tonsillectomies have been reportedly carried out on NHS patients.
Dr James O’Hara, Clinical Senior Lecturer at Newcastle University and Consultant Ear, Nose and Throat surgeon at Newcastle Upon Tyne Hospitals NHS Foundation Trust, said: “Tonsillectomy has been branded as an ‘intervention of limited clinical value’ due to a lack of studies to support the operation.
“Over the last 20 years, the number of tonsillectomies being performed in the UK has halved whilst hospital admissions for complicated tonsillitis have more than doubled.
“There has been variation across the UK in referrals from primary care for tonsillitis, with some patients having to experience three times the recommended number of episodes before being referred for a tonsillectomy.
“Our research should level the threshold for referral for this problem, and clinicians can now be assured that tonsillectomy is effective for those who suffer with recurrent tonsillitis.”
In the study, commissioned by the NIHR, almost 500 patients were randomised to either early tonsillectomy or given treatment such as painkillers and antibiotics.
Participants were only recruited if they met the current national guidance for offering tonsillectomy - seven episodes of tonsillitis in a year, five per year for two years, or three episodes for three years.
Those in the clinical trial who underwent the operation suffered half the number of days with sore throats over the following two years, including the two weeks of sore throats following the procedure.
Cost effective procedure
The Newcastle-led research also showed that it is more cost effective for the NHS to offer tonsillectomy to eligible patients than to treat them by other conventional methods.
Dr O’Hara said: “Whilst we now know that tonsillectomy is effective, patients still need to weigh up the potential benefits in reducing longer-term sore throats with 14 days of pain following the operation.
“There is also a risk of one in five patients bleeding following the operation, with some having to return to hospital. Further research is needed to improve the tonsillectomy operation to make it less painful and reduce the risk of bleeding.”
Professor Andrew Farmer, Director of NIHR’s Health Technology Assessment Programme, said: “These new results provide important findings suggesting that tonsillectomy benefits this group of patients compared to repeated courses of antibiotics and painkillers.
“Once again, high quality independently funded research is providing evidence which could improve health and social care practice and treatments."
Newcastle University and Newcastle Hospitals are both part of Newcastle Health Innovation Partners (NHIP). NHIP is one of eight prestigious Academic Health Science Centres (AHSCs) across the UK, bringing together partners to deliver excellence in research, health education and patient care.
Reference:
Conservative management versus tonsillectomy in adults with recurrent acute tonsillitis in the UK (NATTINA): a multicentre, open-label, randomised controlled trial. Janet Wilson et al. The Lancet.
Patient case study
Secondary school teacher, Elinor Barwick, was the first patient recruited to the Newcastle-led trial as her recurrent acute tonsillitis was impacting her life.
Elinor had suffered terrible sore throats for many years, however, things got significantly worse when she became a teacher as she needed to speak all the time, leaving her in a lot of pain and discomfort.
Elinor’s tonsillitis often meant it was hard to swallow both liquids and food. In addition, her tonsillitis would leave her unable to speak as her throat would become extremely tight and swollen, and she would develop flu-like symptoms – all of which would impact her job and quality of life.
Elinor, of Gosforth, Newcastle, was recruited to trial and was one of the participants given the tonsillectomy procedure.
The mother-of-one said: “Recurrent tonsillitis would impact my life as it would leave me in a lot of pain and, at times, made day-to-day life very difficult.
“When I was asked to be part of the trial I didn’t hesitate to say ‘yes’ because it was being led by Newcastle University and would benefit patients like myself.
“Since I have had my tonsils removed, I’ve not had a day off work due to tonsillitis and my quality of life has very much improved as I no longer suffer from severe sore throats.
“It is great that research into the importance of tonsillectomies in adults with recurrent acute tonsillitis has taken place in Newcastle to help patients like myself in the future.”
Ends
END
This collaborative study between researchers in the UK and Australia is a huge step towards aligning outcome reporting with patient priorities in advanced cancer settings. The study, published in the journal eClinical Medicine (The Lancet Discovery Science), details the development, testing and analysis of this design-specific measure to assess quality of life in patients with recurrent rectal cancer, regardless of treatment intent.
This new measure – called the LRRC–QoL – consists of nine multi-item scales (healthcare services, psychological ...
Substantive changes are needed to improve patient safety in prisons, according to a new study published by the Journal of the Royal Society of Medicine (JRSM) and funded by the National Institute for Health and Care Research (NIHR). Practical changes such as timely access to healthcare services and better processes to mitigate medication-related harm should be prioritised, according to the researchers.
In the first nationwide analysis of patient safety incidents in prisons in England, researchers found that security, staffing constraints and the high turnover of prisoners are among the main barriers to the safe delivery of healthcare ...
As we age, our muscles start to waste. Called sarcopenia, it happens to us all, yet no one has ever understood why and how it happens. Now new research from the Australian Regenerative Medicine Institute (ARMI) at Monash University has used a surprising animal model – the African killifish – to reveal that towards the end of life, our muscles actually reverse to an “early-life” state, slowing mortality. This finding may provide a clue to slowing, halting or even reversing age-related loss of muscle mass and strength.
The research, published ...
UCL Press Release
Under embargo until Thursday 18th May, 01:00 UK time / Wednesday 17th May, 20:00 Eastern US time
Peer reviewed | Literature review | People
One of the world’s largest fundamentalist Christian education groups is teaching its students climate change denial as fact, and still presents the theory of evolution as an ‘absurd and discredited’ conspiracy theory, finds a report by UCL researchers.
Accelerated Christian Education (ACE) is one of the world’s biggest providers of creationist science materials, consisting of reading programmes and a core ...
For the first time, astronomers have observed radio waves emitted by a Type Ia supernova, a type of explosion originating from a white dwarf star. This provides important clues to understand how white dwarfs explode.
A Type Ia (One-A) supernova is the nuclear explosion of a white dwarf star. This type of supernova is well known; these supernovae are used by astronomers to measure cosmological distances and the expansion of the Universe. But the explosion mechanism of Type Ia supernovae is not well understood. Solitary white dwarfs don’t explode, so it is thought that mass accretion from a neighboring companion ...
Kyoto, Japan -- Purple is a color that has historically been associated with nobility around the world. Japan is no exception. However, its distinct murasaki hue is threatened as the native gromwell plant -- synonymous with murasaki -- has become an endangered species.
Disease and cross-breeding with non-native species are partly to blame for murasaki's growing demise.
Now, a research group including Kyoto University, is leading a movement to raise awareness of gromwell's importance in preserving ...
A new study of more than 50,000 US adolescents across the country indicates that vaping nicotine is strongly linked with an increased likelihood of high levels use of binge drinking and cannabis usage.
The findings, published today in the peer-reviewed journal Substance Use and Misuse, will add to growing public health concerns about the increased popularity of electronic cigarette (or ‘vaping’) use among young people.
“While the overall health risks of vaping are lower than smoking, electronic cigarettes are still harmful to adolescents and warrant ongoing ...
Researchers at UCLA Health and Harvard have identified 10 pesticides that significantly damaged neurons implicated in the development of Parkinson’s disease, providing new clues about environmental toxins’ role in the disease.
While environmental factors such as pesticide exposure have long been linked to Parkinson’s, it has been harder to pinpoint which pesticides may raise risk for the neurodegenerative disorder. Just in California, the nation’s largest agricultural producer and exporter, there are nearly 14,000 pesticide products with over 1,000 active ingredients registered for use.
Through a novel pairing ...
A new agreement between Utah State University and Hill Air Force Base will create enhanced learning opportunities for students and spur innovative joint research efforts.
The Education Partnership Agreement was signed on May 11 by USU President Noelle Cockett and Wayne Ayer, a director of the Air Force Sustainment Center’s Engineering and Technical Management Directorate in Ogden.
“There are so many opportunities and technologies that exist within the Air Force that students and faculty can be a part of,” Ayer said. “By ...
ST. LOUIS — The Institute for Healing Justice and Equity (IHJE) at Saint Louis University has launched "Critical Futures," a new podcast about imagining alternative futures.
The first episode "Reimagining Community Partnerships" explores anti-racist health policies and structural racism in the health care system and was produced with support from the Robert Wood Johnson Foundation (RWJF), as part of the work of the Anti-Racism Consortium.
“How do we dismantle these systems? What are we building in its wake to move forward so that we can stop having these conversations? Will that happen in our lifetime? ...
