Total or partial tonsillar resection (tonsillectomy or tonsillotomy) to change the quality of life for adults with recurrent or chronic tonsillitis: study protocol for a randomised controlled trial.
BACKGROUND
Tonsillar surgery has been used for decades to treat recurrent and chronic tonsillitis in adults. Recurrent and chronic tonsillitis result in disturbing symptoms, treatment costs, sick leave, and impaired quality of life (QoL). Theoretically, removing all or part of the altered pathological palatal lymphoid tissue alleviates the symptoms and enhances the QoL. Whether this is true with total or partial tonsillar resection (tonsillectomy (TE) and tonsillotomy (TT), respectively) has not been reported in a randomised trial yet.


METHODS
We conduct a multicentre, partly blinded, randomised, 6-month, parallel-group clinical study including 285 adult participants referred to surgical treatment for chronic or recurrent tonsillitis. The participants will either have TE, TT or watchful waiting (WW). The primary outcome will be the difference between the mean disease-specific Tonsillectomy Outcome Inventory-14 (QoL questionnaire) scores at 6 months. Comparison is made firstly between the combined TE+TT and WW groups (superiority analysis), and secondly between the TE and TT groups (non-inferiority analysis).


DISCUSSION
This study will add significant new information to the effects and harms of TE and TT procedures in the treatment of adults with chronic or recurrent tonsillitis.


TRIAL REGISTRATION
ClinicalTrials.gov: NCT04657549.
['Laajala|Aleksi|A|http://orcid.org/0000-0001-5202-7828', 'Tokola|Paulus|P|', 'Autio|Timo J|TJ|', 'Koskenkorva|Timo|T|', 'Tastula|Mikko|M|', 'Ohtonen|Pasi|P|', 'Läärä|Esa|E|', 'Alho|Olli-Pekka|OP|']
D000328:Adult D002908:Chronic Disease D006801:Humans D015337:Multicenter Studies as Topic D014066:Palatine Tonsil D011788:Quality of Life D016032:Randomized Controlled Trials as Topic D014068:Tonsillectomy D014069:Tonsillitis
Tonsillectomy Tonsillotomy Quality of life Chronic tonsillitis Randomised controlled trial Treatment Recurrent tonsillitis