Tonsillectomy is a traditional treatment for patients with recurrent streptococcal tonsillopharyngitis. However, according to a recent review by the Cochrane Collaboration, no evidence has been found of the effectiveness of this operation in adults. A randomized, controlled study in Finland evaluated the short-term efficacy and safety of tonsillectomy in adult patients with recurrent streptococcal tonsillopharyngitis.

The study involved 70 patients with a documented relapse of pharyngitis caused by group A streptococcus. In the experimental group (n = 36), a tonsillectomy was performed and in the control group, one observation (n = 34) a been carried out. Within 90 days, the risk of episodes of streptococcal pharyngitis was assessed. All episodes of pharyngitis, duration of symptoms in days and adverse events were also taken into account.

The mean follow-up period was 164 (± 63) days in the control group and 170 (± 12) in the group of patients undergoing tonsillectomy. During the first 90 days, relapse of streptococcal pharyngitis was observed in 24% (8/34) of the control group and in 3% (1/36) of the operated patients (difference of 21%; confidence interval [ 95% CI] from 6% to 36%). The number of patients to be operated on to prevent an episode of pharyngitis was 5 (95% CI 3 to 16). During the entire follow-up period, the frequency of all episodes of pharyngitis, the duration of sore throat and fever were significantly lower in the group of patients undergoing surgery. The most common side effect of tonsillectomy was postoperative sore throat (mean duration 13 ± 4 days).

It should be borne in mind that during surgery, complications such as sensitivity disturbances, earache, fever, dehydration, dental damage, burns, soft tissue damage are possible. There is also a low probability of life-threatening complications (mortality ranges from 1 in 16,000 to 1 in 35,000). In this regard, when deciding on the issue of surgical treatment, it is necessary to weigh the risk of complications and the expected benefits of the intervention.

For example, performing a tonsillectomy in adult patients with recurrent streptococcal tonsillopharyngitis causes a decrease in the frequency of relapses, other pharyngeal infections, and the number of days the patient has a sore throat.