DÄ internationalArchive49/2010Not a Trivial Procedure
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The authors retrospectively studied adults who underwent tonsillectomies after recurrent tonsillitis. They used quality of life scores and measured number of days off work because of illness and the number of visits to doctors.

It is surprising that they did not include the not insubstantial rate of perioperative and postoperative complications in the results of their study and the discussion section.

The number of postoperative hemorrhages is 1.4% (1) to 3.3% (2).

The fact that a simple PubMed search using the search terms “tonsillectomy” and “perioperative or postoperative complications” shows up 24 meta-analyses. To me, this confirms that the procedure is not trivial.

Two years ago, Deutsches Ärzteblatt published a CME article on the topic of tonsillectomy in children (3). The authors postulated rightly that the indication for this intervention should be very narrowly defined.

The article by Senska et al is mostly of no value in this respect because it is subject to bias, especially in terms of the included patients: someone who has decided to have a tonsillectomy is bound to be convinced by this procedure and will give positive scores in order not to have to have to live with the feeling that they have risked health and life unnecessarily.

DOI: 10.3238/arztebl.2010.0874a

Dr. med. Günther Egidi
Huchtinger Heerstr. 41
28259 Bremen, Germany

1.
Bennett AM, Clark AB, Bath AP, Montgomery PQ: Meta-analysis of the timing of haemorrhage after tonsillectomy: an important factor in determining the safety of performing tonsillectomy as a day case procedure. Clin Otolaryngol 2005; 30(5): 418–23. MEDLINE
2.
Krishna P, Lee D: Post-tonsillectomy bleeding: a meta-analysis.
Laryngoscope 2001; 111(8): 1358–61. MEDLINE
3.
Stuck BA, Windfuhr JP, Genzwürker H, Schroten H, Tenenbaum T, Götte K: Die Tonsillektomie im Kindesalter. Dtsch Arztebl Int 2008; 105(49): 852–60. VOLLTEXT
4.
Senska G, Ellermann S, Ernst S, Lax H, Dost Ph: Recurrent tonsillitis in adults—the quality of life after tonsillectomy. Dtsch Arztebl Int 2010; 107(36): 622–8. VOLLTEXT
1.Bennett AM, Clark AB, Bath AP, Montgomery PQ: Meta-analysis of the timing of haemorrhage after tonsillectomy: an important factor in determining the safety of performing tonsillectomy as a day case procedure. Clin Otolaryngol 2005; 30(5): 418–23. MEDLINE
2.Krishna P, Lee D: Post-tonsillectomy bleeding: a meta-analysis.
Laryngoscope 2001; 111(8): 1358–61. MEDLINE
3.Stuck BA, Windfuhr JP, Genzwürker H, Schroten H, Tenenbaum T, Götte K: Die Tonsillektomie im Kindesalter. Dtsch Arztebl Int 2008; 105(49): 852–60. VOLLTEXT
4.Senska G, Ellermann S, Ernst S, Lax H, Dost Ph: Recurrent tonsillitis in adults—the quality of life after tonsillectomy. Dtsch Arztebl Int 2010; 107(36): 622–8. VOLLTEXT