C Hopkins1, R Almeyda2, H Alreefy1, H Ismail-Koch3, J Lim4, V Possamai5, S Powell6, R Sharma7, I Hore1. 1. Evelina London Children's Hospital,Guy's and St Thomas' NHS Trust,London,UK. 2. John Radcliffe Hospital,Oxford,UK. 3. Southampton Hospital,Gillingham,UK. 4. Medway Maritime Hospital,Gillingham,UK. 5. Birmingham Children's Hospital,Newcastle upon Tyne,UK. 6. Freeman Hospital,Newcastle upon Tyne,UK. 7. Alder Hey Children's Hospital,Liverpool,UK.
Abstract
OBJECTIVE: This study aimed to measure changes in disease-specific quality of life in children following tonsillectomy or adenotonsillectomy. METHODS: A multicentre prospective cohort study was performed involving seven ENT departments in England. A total of 276 children entered the study over a 2-month period: 107 underwent tonsillectomy and 128 adenotonsillectomy. Forty-one children referred with throat problems initially managed by watchful waiting were also recruited. The follow-up period was 12 months. Outcome measures were the T14, parental impressions of their child's quality of life and the number of days absent from school. RESULTS: One-year follow-up data were obtained from 150 patients (52 per cent). The mean baseline T14 score in the non-surgical group was significantly lower (T14 = 23) than in the tonsillectomy group (T14 = 31) or the adenotonsillectomy group (T14 = 35; p < 0.001). There was a significant improvement in the T14 scores of responders in all groups at follow up. The effect size was 1.3 standard deviations (SD) for the non-surgical group, 2.1 SD for the tonsillectomy group and 1.9 SD for the adenotonsillectomy group. Between-group differences did not reach statistical significance. A third of children in the non-surgical group underwent surgery during the follow-up period. CONCLUSION: Children who underwent surgical intervention achieved a significant improvement in disease-specific quality of life. Less severely affected children were managed conservatively and also improved over 12 months, but 1 in 3 crossed over to surgical intervention.
OBJECTIVE: This study aimed to measure changes in disease-specific quality of life in children following tonsillectomy or adenotonsillectomy. METHODS: A multicentre prospective cohort study was performed involving seven ENT departments in England. A total of 276 children entered the study over a 2-month period: 107 underwent tonsillectomy and 128 adenotonsillectomy. Forty-one children referred with throat problems initially managed by watchful waiting were also recruited. The follow-up period was 12 months. Outcome measures were the T14, parental impressions of their child's quality of life and the number of days absent from school. RESULTS: One-year follow-up data were obtained from 150 patients (52 per cent). The mean baseline T14 score in the non-surgical group was significantly lower (T14 = 23) than in the tonsillectomy group (T14 = 31) or the adenotonsillectomy group (T14 = 35; p < 0.001). There was a significant improvement in the T14 scores of responders in all groups at follow up. The effect size was 1.3 standard deviations (SD) for the non-surgical group, 2.1 SD for the tonsillectomy group and 1.9 SD for the adenotonsillectomy group. Between-group differences did not reach statistical significance. A third of children in the non-surgical group underwent surgery during the follow-up period. CONCLUSION:Children who underwent surgical intervention achieved a significant improvement in disease-specific quality of life. Less severely affected children were managed conservatively and also improved over 12 months, but 1 in 3 crossed over to surgical intervention.