Peter J. Koltai MD, FACS, FAAP

Publication Details

  • Tonsillitis index: An objective tool for quantifying the indications for tonsillectomy for recurrent acute tonsillitis INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY Fujihara, K., Goto, H., Hiraoka, M., Hayashi, M., Hotomi, M., Tamura, S., Kuki, K., Yamanaka, N., Koltai, P. J. 2005; 69 (11): 1515-1520

    Abstract:

    This report is a preliminary exploration of the concept of a "Tonsillectomy Index" (TI) as an objective tool for quantifying the indications for tonsillectomy for recurrent acute tonsillitis (AT). The TI is derived by multiplying the number of episodes of AT by the number of years during which the episodes of AT occurred. Our objective in this study was to investigate whether there is a relationship between the natural history of AT, the immunological functions of tonsils and our proposed TI. For the natural history of AT, we medically followed 11 children with a history of AT for 5 years. When TI was equal to or greater than 8 (TI> or =8), the children suffered a significantly greater number of episodes of AT. For the immunological portion of our study, we enrolled 36 children and 46 adults undergoing tonsillectomy for either AT (study group) or tonsillar hypertrophy (control group, CG). We analyzed the co-stimulatory signals, CD80 and CD86 on tonsillar B-lymphocytes. The expression rates of CD80 and CD86 in the AT group with TI> or =8 were significantly decreased compared to those with TI was less than 8 (TI<8), as well as with those in control (tonsillar hypertrophy) group. Our preliminary findings suggest that when the TI> or =8, the tonsils have deteriorated immunologically and spontaneous resolution of recurrent AT is less likely to occur, hence tonsillectomy is appropriate. TI may be a useful tool for surgical decision making.

    View details for DOI 10.1016/j.ijporl.2005.04.007

    View details for Web of Science ID 000233098700009

    View details for PubMedID 15979731

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