Researchers at Brigham and Women’s Hospital (BWH) have found that adults who have tonsillectomies to treat their chronic, recurring tonsillitis take fewer sick days and less medication than those who opt to leave their tonsils in and repeatedly treat the condition with antibiotics.
The study, which was published in the November issue of the Annals of Otology, Rhinology and Laryngology, followed 83 chronic tonsillitis sufferers over a three-year period. BWH researchers found that removing the tonsils was ultimately more effective than antibiotic treatments because those patients who had their tonsils extracted missed only 0.6 days of work a year on average after their tonsillectomy, versus 9.2 workdays before the surgery.
“The myth persists that if you’re an adult, you shouldn’t have your tonsils removed,” said Assistant Professor of Otology and Laryngology Neil Bhattacharyya of BWH. “But for people who get tonsillitis several times a year, the surgery makes sense, medically, financially, and from a quality-of-life perspective.”
Bhattacharyya’s findings also included how long patients remained on antibiotics over the course of a year. Before tonsillectomy, patients spent an average of six and a half weeks a year taking antibiotics, whereas after tonsillectomy the same patients averaged less than a day per year on antibiotics.
Visits to doctors’ offices also declined sharply for people whose tonsils had been removed. Before tonsillectomy, patients averaged six doctor’s visits a year for tonsil and throat problems, compared with the 0.3 visits a year on average for those after tonsillectomy.
“When you factor in all of the sick time with the expense associated with the antibiotics and the doctor’s visits, deciding to keep your tonsils can be the less attractive option for many chronic tonsillitis sufferers,” said Bhattacharyya. “Even when you consider that it takes a week to recover from the surgery, patients who had them removed were less sick, less often, for several years after the procedure.”
Tonsillitis occurs when the tonsils – lymphoid tissue located in the back of the throat – become infected, either by bacteria or a virus. Bacterial infection of the tonsils, which tends to be more severe, can be treated in many cases using antibiotics. Viral infections, however, cannot be treated with medication.
Most insurance companies determine whether a tonsillectomy is covered by considering how many times a year the patient experiences tonsillitis. The average, approximated cost of the surgery is $2,500. Bhattacharyya showed that even from an economic standpoint tonsillectomy is beneficial, with savings from fewer infections recouping the costs of the tonsillectomy within two years after the procedure.
“When evaluating whether or not to cover this kind of surgery, insurance companies should think long term, both in terms of the patient’s quality of life and the costs associated with the reoccurrence of this condition,” said Bhattacharyya. “As we have shown, for some adults, tonsillectomies make practical, and medical, sense.”
Bhattacharyya cautioned that tonsillectomies are not the right course of treatment for everyone, and sufferers should consult with their doctors to determine the best course of action.