Man with tonsillitis

Tonsillectomy found to be both clinically and cost effective for NHS

Adults suffering from recurrent sore throats are set to receive better healthcare after new research found that removing a patients tonsils is both clinically and cost effective for the NHS.

The findings come from Newcastle University’s NATTINA trial which randomly assigned around 500 patients to either a tonsillectomy or alternative treatments like painkillers and antibiotics.

The researchers found that those who underwent the surgery suffered half the amount of sore throats in the following two years, compared to those who were given the other treatments.

While tonsillectomies are widely considered to improve patients’ quality of life, the number of these procedures being carried out on the NHS has been declining.

Clinical senior lecturer at Newcastle University and consultant ear, nose and throat surgeon at Newcastle upon Tyne Hospitals NHS Foundation Trust, Dr James O’Hara, explained: “Tonsillectomy has been branded as an ‘intervention of limited clinical value’ due to a lack of studies to support the operation.

“Over the last 20 years, the number of tonsillectomies being performed in the UK has halved while hospital admissions for complicated tonsillitis have more than doubled.”

Those recruited to the trial had to align with the current national guidance for tonsillectomy, which is either seven episodes of tonsillitis in a year, five per year over two years, or three instances for three straight years.

Dr O’Hara said the results of the trial mean that clinicians can be “assured” that tonsillectomy procedures are effective.

“Whilst we now know that tonsillectomy is effective, patients still need to weigh up the potential benefits in reducing longer-term sore throats with 14 days of pain following the operation,” he also added however.

“There is also a risk of one in five patients bleeding following the operation, with some having to return to hospital. Further research is needed to improve the tonsillectomy operation to make it less painful and reduce the risk of bleeding.”

The research was funded through the National Institute for Health and Care Research (NIHR).

Director of NIHR’s Health Technology Assessment Programme, Professor Andrew Farmer, commented: “Once again, high-quality independently funded research is providing evidence which could improve health and social care practice and treatments."

NHE March/April 2024

NHE March/April 2024

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