Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-26T22:58:46.140Z Has data issue: false hasContentIssue false

General practitioners' versus consultants' perspective on indications for paediatric tonsillectomy: current trends

Published online by Cambridge University Press:  14 December 2011

J Manickavasagam*
Affiliation:
Otorhinolaryngology, Head and neck surgery, Doncaster Royal Infirmary, UK
S Ali
Affiliation:
Otorhinolaryngology, Head and neck surgery, Doncaster Royal Infirmary, UK
M S Quraishi
Affiliation:
Otorhinolaryngology, Head and neck surgery, Doncaster Royal Infirmary, UK
*
Address for correspondence: Mr J Manickavasagam, 14 Brocco Bank, Sheffield S11 8RR, UK E-mail: jaiganeshkalpana@yahoo.co.uk

Abstract

Aims:

We undertook a study to ascertain what factors general practitioners consider important when referring children for tonsillectomy, and to compare these views with those of consultant ENT surgeons.

Methods:

Web-based questionnaire study.

Results:

A total of 141 general practitioners and 146 consultants responded. Tonsillectomy in children was regarded as a useful operation by 65 per cent of general practitioners and 98 per cent of consultant ENT surgeons. This difference was statistically significant (p < 0.001, chi-square test). In 1994, Donnelly et al. found that 92 per cent of general practitioners considered tonsillectomy in children a useful operation; our results were significantly different (p < 0.001, chi-square test).

Conclusions:

There is a good level of awareness and agreement on the currently accepted indications for paediatric tonsillectomy in both groups. However, there were important areas of difference between the two groups with regard to ‘glue ear’, recurrent ear infections and snoring. Standardised indications for tonsillectomy should be effectively disseminated to general practitioners.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented as a poster at the 13th British Academic Conference in Otolaryngology and ENT Expo 8–10 July 2009, Liverpool, UK

References

1Rosefsky, JB. Tonsillectomies and adenotonsillectomies—will the debate never be over? Pediatrics 2003;112:205Google ScholarPubMed
2Rutkow, IM. Ear nose throat operations in the United States, 1979–1984. Arch Otolaryngol Head Neck Surg 1987;112:873–7CrossRefGoogle Scholar
3Discolo, CM, Darrow, DH, Koltai, PJ. Infectious indications for tonsillectomy. Pediatr Clin North Am 2003;50:445–58CrossRefGoogle ScholarPubMed
4Darrow, DH, Siemens, C. Indications for tonsillectomy and adenoidectomy. Laryngoscope 2002;112:69Google Scholar
5Donnelly, MJ, Quraishi, MS, McShane, DP. Indications for paediatric tonsillectomy GP versus consultant perspective. J Laryngol Otol 1994;108:131–4CrossRefGoogle ScholarPubMed
6Management of Sore Throat and Indications for Tonsillectomy. In: http://www.sign.ac.uk/guidelines/fulltext/117/index.html [27 May 2011]Google Scholar
7Deutsch, ES. Tonsillectomy and adenoidectomy. Changing indications. Pediatr Clin North Am 1996;43:1319–38Google Scholar
8Paradise, JL, Bluestone, CD, Colborn, DK, Bernard, BS, Smith, CG, Rockette, HE et al. Adenoidectomy and adenotonsillectomy for recurrent acute otitis media: parallel randomized clinical trials in children not previously treated with tympanostomy tubes. JAMA 1999;282:945–53Google Scholar
9Paradise, JL, Bluestone, CD, Rogers, KD, Taylor, FH, Colborn, DK, Bachman, RZ et al. Efficacy of adenoidectomy for recurrent otitis media in children previously treated with tympanostomy-tube placement: results of parallel randomized and nonrandomized trials. JAMA 1990;263:2066–73CrossRefGoogle ScholarPubMed
10Cable, HR, Batch, AG, Stevens, DJ. The relevance of physical signs in recurrent tonsillitis in children. J Laryngol Otol 1986;100:1047–51CrossRefGoogle ScholarPubMed
11Barr, GS, Crombie, IK. Comparision of size of tonsils in children with recurrent tonsillitis and in controls. BMJ 1989;298:804Google Scholar
12Lock, C, Wilson, J, Steen, N, Eccles, M, Mason, H, Carrie, S et al. North of England and Scotland Study of Tonsillectomy and Adeno-tonsillectomy in Children (NESSTAC): a pragmatic randomised controlled trial with a parallel nonrandomised preference study. Health Technol Assess 2010;14:1190Google ScholarPubMed
13Burton, MJ, Glasziou, PP. Tonsillectomy or adeno-tonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev 2009;(1):CD001802CrossRefGoogle ScholarPubMed
14ENT UK Position Papers. In: http://www.entuk.org/position_papers/index_html [27 May 2011]Google Scholar