[Current Consideration of Tonsillectomy and Tonsillotomy]

Abstract

What is right? Tonsillotomy or tonsillectomy? Moreover, when and what has to be preferred? Is the discussion never ending? No, and this is good. Tonsil surgery is and will remain a frequent surgical procedure for the otolaryngologist. Especially, because many children are operated, and because - also rare - significant complications can occur, a quality-controlled benefit-risk-analysis is important. Part of this is systematic analysis of the evidence of the benefits and risks of tonsillotomy and tonsillectomy, as it was performed recently by the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) by order of the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA). One result was the implementation of the tonsillotomy as a regular service paid by the insurance companies. Nevertheless, the discussion is not yet concluded. Actually, a randomized controlled trial is in preparation sponsored by the G-BA to proof the non-inferiority of tonsillotomy against tonsillectomy for the treatment of patients with recurrent acute tonsillitis. The present article on ENT specialist knowledge should put the reader, especially ENT residents, in a position to advice patients and their relatives on the pros and cons of tonsil surgery.