Patient-reported outcome measures (PROMs) are used increasingly to fill an ‘evidence gap’ where healthcare rationing threatens particular treatments. Tonsillectomy is a long-established and effective treatment for recurrent tonsillitis and obstructive sleep apnoea (OSA) in children. The T-14 outcome measure examines disease-specific quality of life related to these two conditions. The authors present serial T-14 scores from a cohort of patients undergoing adenotonsillectomy or tonsillectomy. Scores were obtained preoperatively and at three, six, 12 and 24 months, with complete responses in 44 patients / parents. The results demonstrate a significant decrease in T-14 score from preoperative to three-month follow-up – from a mean score of 33.3/70 to a mean score of 3.4/70. Most importantly, these improvements in symptomatology and quality of life are sustained through to 24-month follow-up. The results do not take account of the natural history of paediatric OSA and frequent tonsillitis, which tends towards improvement over time for many patients.
Nevertheless, it provides good evidence for rapid and prolonged improvement in quality of life after adenotonsillar surgery, in patients meeting the relevant diagnostic criteria (e.g. SIGN).
This, and hopefully further controlled research, may help to safeguard against further assaults on the provision of valuable ENT surgical procedures.
