Literature Review: Evaluation of the Use of Tonsillectomy as a Surgical Intervention in Patients with Recurrent Tonsillitis
Abstract
Recurrent tonsillitis is one of the most common diagnoses in ENT practice that significantly impacts patients' quality of life. Although antibiotic therapy is the first line of treatment, persistent infection often requires surgical intervention. This study aims to evaluate the clinical efficacy, impact on quality of life, and pharmacoeconomic aspects of tonsillectomy compared to conservative management. The method used was a narrative systematic review of international literature from 2016 to 2025 obtained from Google Scholar, PubMed, and NCBI. The results of the search of 17 selected articles showed that tonsillectomy significantly reduced the frequency of sore throat episodes and antibiotic use compared to medical therapy. The use of modern techniques such as Coblation has been shown to reduce postoperative pain and accelerate recovery compared to conventional techniques. In addition, tonsillectomy provides significant long-term improvements in quality of life, both physically and mentally. In conclusion, tonsillectomy is an effective, safe, and cost-efficient surgical procedure for patients with recurrent tonsillitis, with strict indications to optimize clinical outcomes.
References
Albornoz, A. E., Rana, M., Hayes, J., Englesakis, M., Tsang, M., Amin, R., ... & Aoyama, K. (2024). Perioperative clinical practice recommendations for pediatric tonsillectomy: a systematic review: AE Albornoz et al. Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 71(2), 187-200. https://doi.org/10.1007/s12630-023-02668-z
Alenezi, M. M., Al-Harbi, F. A., Almoshigeh, A. N. M., Alruqaie, S. S., Alshahrani, N. M., Alamro, A. M., ... & Alharbi, L. A. (2025). Comparison of post-tonsillectomy hemorrhage rate after different tonsillectomy techniques: systematic review and meta analysis. Clinics and Practice, 15(5), 85. https://doi.org/10.3390/clinpract15050085
Attar, T. S., Bhavsar, N. P., Rathod, P. B., Shinde, A., & Nath, H. S. (2025). Cost Analysis of Antibiotic Prophylaxis in General Surgery Department of a Tertiary Care Hospital: A Prospective Cross-sectional Study. Asian Journal of Public Health Practice, 2(2), 53-59. https://doi.org/10.4103/AJPHP.AJPHP_8_25
Ban, J., Hu, Y., Huang, H., Zhang, P., Dong, S., Zhou, Y., ... & Su, Y. (2026). Symptom experiences of patients after cardiac valve surgery: A qualitative study. Plos one, 21(3), e0342597. https://doi.org/10.1371/journal.pone.0342597
Carlson, M. L., Lohse, C. M., Link, M. J., Tombers, N. M., McCaslin, D. L., Saoji, A. A., Hutchins, M., & Yost, K. J. (2023). Development and Validation of a New Disease-Specific Quality of Life instrument for Sporadic Vestibular Schwannoma: the Mayo Clinic Vestibular Schwannoma Quality of Life Index. Journal of Neurosurgery, 138(4), 981–991. https://doi.org/10.3171/2022.7.JNS221104
Cavalcante, L. F. F., Costa, G., Battistuta, S. M., Makabe, P. F., Bueno, I. S. F., Yuamoto, B., Vilela, F. E. G., & Sáfadi, M. A. P. (2025). Surgical Management for Periodic Fever, Aphthous Stomatitis, Pharyngitis and Cervical Adenitis (PFAPA) Syndrome: a Systematic Review and Meta-Analysis. Jornal de Pediatria, 101(4), 494–500. https://doi.org/10.1016/j.jped.2025.03.006
Choudhari, N. P. (2026). Redefining Standards: Why Homoeopathy Deserves a Place in the Management of Peritonsillar Abscess?. Indian Journal of Homoeopathy and Integrative Medicine, 1(1), 12-17.
Davies, H., Russell, J., Varghese, A., Holmes, H., Soares, M. O., Woods, B., ... & Robotham, J. V. (2023). Developing a modeling framework for quantifying the health and cost implications of antibiotic resistance for surgical procedures. MDM Policy & Practice, 8(1), 23814683231152885. https://doi.org/10.1177/23814683231152885
De Maria, L., Delvecchio, G., Sponselli, S., Cafaro, F., Caputi, A., Giannelli, G., ... & Vimercati, L. (2023). SARS-CoV-2 infections, re-infections and clinical characteristics: a two-year retrospective study in a large university hospital cohort of vaccinated healthcare workers. Journal of Clinical Medicine, 12(21), 6800. https://doi.org/10.3390/jcm12216800
Douglas, C. M., Lang, K., Whitmer, W. M., Wilson, J. A., & Mackenzie, K. (2017). The Effect of Tonsillectomy on the Morbidity from Recurrent Tonsillitis. Clinical Otolaryngology, 42(6), 1206–1210. https://doi.org/10.1111/coa.12850
Farkas, H. S., & Leschek, E. W. (2024). Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) in a two-year-old. Open journal of clinical & medical case reports, 10(14), 2245.
Galindo Torres, B. P., De Miguel García, F., & Whyte Orozco, J. (2018). Tonsillectomy in Adults: Analysis of Indications and Complications. Auris Nasus Larynx, 45(3), 517–521. https://doi.org/10.1016/j.anl.2017.08.012
Guntinas-Lichius, O., Geißler, K., Asendorf, T., Tostmann, R., & Löhler, J. (2021). Tonsillectomy Versus Tonsillotomy for Recurrent Acute Tonsillitis in Children and Adults (TOTO): Study Protocol for a Randomized Non-Inferiority Trial. Trials, 22(1), 479. https://doi.org/10.1186/s13063-021-05434-y
Guntinas-Lichius, O., Geissler, K., Mäkitie, A. A., Ronen, O., Bradley, P. J., Rinaldo, A., ... & Ferlito, A. (2023). Treatment of recurrent acute tonsillitis—a systematic review and clinical practice recommendations. Frontiers in surgery, 10, 1221932. https://doi.org/10.3389/fsurg.2023.1221932
Houborg, H. I., & Klug, T. E. (2022). Quality of life after tonsillectomy in adult patients with recurrent acute tonsillitis: a systematic review. European Archives of Oto-Rhino-Laryngology, 279(6), 2753-2764.
Ibrahim, A. A., Alsayed, A. A., Mahmoud, M. A., Hassan, A. H. A., & Hamdan, A. M. (2025). The effect of tonsillectomy on clinical manifestations in Familial Mediterranean fever. International Journal of Pediatric Otorhinolaryngology, 189, 112231. https://doi.org/10.1016/j.ijporl.2025.112231
Jacob, T., Leshno, M., Carmel‐Neidermann, N. N., Kampel, L., Warshavsky, A., Mansour, J., Assadi, N., Muhanna, N., & Horowitz, G. (2024). Antibiotics or Tonsillectomy for Adult Recurrent Tonsillitis: Analyzing the Lesser of Two Evils. The Laryngoscope, 134(5), 2153–2161. https://doi.org/10.1002/lary.31139
Jurkiewicz, A., Bant, P., Szczygielski, K., Kaczmarczyk, M., & Jurkiewicz, D. (2025). Long-Term Impact of Tonsillectomy on Quality of Life (QoL) in Patients with Palatine Tonsillitis and Palatine Tonsillar Hypertrophy. Journal of Clinical Medicine, 14(18), 6404. https://doi.org/10.3390/jcm14186404
Karim, A., Hassan, M. B., Nasir, M., Abdullah, F., Fatima, M., Kumar, S., ... & Yokolo, H. (2026). G-CSF biosimilars vs. originator filgrastim for febrile neutropenia prophylaxis: systematic review of cost-effectiveness, safety, and clinical outcomes. Annals of Medicine and Surgery, 10-1097. https://doi.org/10.1097/MS9.0000000000004732
Keskin, D. D., Dinç, A. S. K., & Winkler, A. A. (2025). Meeting Organ for ENT and Pediatric Pulmonology: Tonsils. In Pediatric Airway Diseases (pp. 491-515). Cham: Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-74853-0_38
Magradze, G., Deffner, F., Ketterer, M. C., Becker, C., & Knopf, A. (2026). Routine Histopreparations After Tonsillectomy, Tonsillotomy, Adenotomy or Conchotomy: A Necessary Diagnosis in Times of Dwindling Resources?. Journal of Clinical Medicine, 15(3), 1195. https://doi.org/10.3390/jcm15031195
Mesolella, M., Allosso, S., Coronella, V., Massimilla, E. A., Mansi, N., Motta, G., ... & Motta, G. (2023). Extracapsular tonsillectomy versus intracapsular tonsillotomy in paediatric patients with OSAS. Journal of personalized medicine, 13(5), 806. https://doi.org/10.3390/jpm13050806
Mukerji, S. S., Rath, S., Zhang, W. Q., Zhu, H., Anand, G. S., Jones, J. K., ... & Bedwell, J. R. (2022). Extracapsular versus intracapsular tonsillectomy: outcomes in children with a focus on developmental delay. International Journal of Pediatric Otorhinolaryngology, 152, 110978. https://doi.org/10.1016/j.ijporl.2021.110978
Mwabu, A. K., Mutai, W. C., Jaoko, W., Mwaniki, J. N., & kiiru, J. N. (2026). Antibiotic Seeking Pathways and Patterns of Usage among Patients with Productive Coughs Attending Selected Chest Clinics in Nairobi County, Kenya. medRxiv, 2026-04. https://doi.org/10.64898/2026.04.04.26350147
Piitulainen, J. M., Uusitalo, T., Sjöblom, H. M., Ivaska, L. E., Jegoroff, H., Kauko, T., ... & Jero, J. (2022). Intracapsular tonsillectomy in the treatment of recurrent and chronic tonsillitis in adults: a protocol of a prospective, single-blinded, randomised study with a 5-year follow-up (the FINITE trial). BMJ open, 12(9), e062722. https://doi.org/10.1136/bmjopen-2022-062722
Rosiak, K., Waszak, P. M., Pierucka, M., Dydjow-Bendek, D., Zagożdżon, P., Trzeciak-Bilska, K., & Knitter, E. (2026). Depression, trauma, stressful life events and childhood infections in patients with multiple sclerosis in the Polish population–a case-control study. Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii, 35(1), 19-27. https://doi.org/10.5114/ppn.2026.159798
Rossin, G., Biasatti, A., Iachimovsky, I. A., Braulin, L., Zucchi, A., Cai, T., ... & Liguori, G. (2026). Preventing Parastomal Hernias After Radical Cystectomy with Ileal Conduit: A Systematic Review Regarding Surgical Prophylactic Techniques. Journal of Personalized Medicine, 16(1), 40. https://doi.org/10.3390/jpm16010040
Sakina, S., Arpana, T., Ankitha, D., Sravani, E., & Vishruth, G. (2026). Drug Utilisation Evaluation Of Drugs Used In The Treatment Of Upper Respiratory Tract Infection In Tertiary Care Hospital. Journal of Scientific Research and Technology, 20-46.
Salzano, G., Digiacomo, A., Dello Stritto, G., Orsini, A., De Archangelis, R., Cicchetti, R., ... & Marchioni, M. (2026). Artificial intelligence in bladder cancer management: a narrative review of diagnostic and surgical advances and current limitations. Expert Review of Anticancer Therapy, (just-accepted). https://doi.org/10.1080/14737140.2026.2619018
Sheet, M. S., Al-Banna, A. F., Emanuel, E. S., Mohammed, A. A., & Alnori, H. (2022). Coblation Versus Cold Dissection Tonsillectomy: A Comparative Study. Indian Journal of Otolaryngology and Head & Neck Surgery, 74(S3), 5706–5711. https://doi.org/10.1007/s12070-022-03079-0
Sheffer, N., Pansky, I., Hazan, I., Cohen, O., Tripto, I. G., Yafit, D., ... & Ziv, O. (2026). Association of post-tonsillectomy fever with postoperative complications. European Archives of Oto-Rhino-Laryngology, 1-6. https://doi.org/10.1007/s00405-026-10094-2
Siciliano, M., de Scisciolo, M., Fratini, A., Sottani, C., Giordani, F., & Brunetti, V. (2026). Advances in Non-CPAP Management of Obstructive Sleep Apnea: Spotlight on Pharmacological Therapies. Journal of Personalized Medicine, 16(2), 105. https://doi.org/10.3390/jpm16020105
Tanjung, F. F., & Imanto, M. (2016). Indikasi Tonsilektomi Pada Laki‐Laki Usia 19 Tahun dengan Tonsilitis Kronis. Fakultas Kedokteran, Universitas Lampung, 5, 22–25.
Tengen, M. A., Lampiley, A., Salifu, A. S., & Wuni, F. K. (2026). Quality of life of young children pre-adenotonsillectomy: a study at a regional hospital in Ghana. International Journal of Africa Nursing Sciences, 100987. https://doi.org/10.1007/s00405-022-07260-7
Tzelnick, S., Hilly, O., Vinker, S., Bachar, G., & Mizrachi, A. (2020). Long‐Term Outcomes of Tonsillectomy for Recurrent Tonsillitis in Adults. The Laryngoscope, 130(2), 328–331. https://doi.org/10.1002/lary.27928
Wardoyo, F. A., Bakrie, E. R., & Purnamasari, F. (2025). Karakteristik Pasien Tonsilektomi di RSUD Waled Cirebon Periode Tahun 2022 – 2023. Ibnu Sina: Jurnal Kedokteran Dan Kesehatan - Fakultas Kedokteran Universitas Islam Sumatera Utara, 24(1), 213–221. https://doi.org/10.30743/ibnusina.v24i1.727
Wilson, J. A., O’Hara, J., Fouweather, T., Homer, T., Stocken, D. D., Vale, L., Haighton, C., Rousseau, N., Wilson, R., McSweeney, L., Wilkes, S., Morrison, J., MacKenzie, K., Ah-See, K., Carrie, S., Hopkins, C., Howe, N., Hussain, M., Mehanna, H., … Teare, M. D. (2023). Conservative Management Versus Tonsillectomy in Adults with Recurrent Acute Tonsillitis in the UK (NATTINA): a Multicentre, Open-Label, Randomised Controlled Trial. The Lancet, 401(10393), 2051–2059. https://doi.org/10.1016/S0140-6736(23)00519-6
Windfuhr, J. P. (2016). Indications for Tonsillectomy Stratified by the Level of Evidence. GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery, 15, Doc09. https://doi.org/10.3205/cto000136
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