Open AccessAdenotonsillar Surgery and Guidelines in Italy
Author(s) -
Motta Gaetano,
Testa Domenico,
Spadera Lucrezia,
Landolfo Pasquale Gianluca,
Massimilla Eva Aurora,
Motta Sergio
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451426a325
Subject(s) - tonsillectomy , medicine , incidence (geometry) , adenoidectomy , otorhinolaryngology , presentation (obstetrics) , pediatrics , statistical significance , psychological intervention , surgery , physics , psychiatry , optics
Objective 1) Ascertain the impact that guidelines on (adeno)‐tonsillectomy have had on the clinical behavior of ENT specialists in Italy. 2) Evaluate the indications—inclusion criteria—for adeno‐tonsillar surgery in children, adopted by ENT specialists, particularly referring to comorbidities. Method A multicentric study including 14770 children undergoing (adeno)‐tonsillectomy in 2002, 2004, 2006, and 2008 was conducted in 14 Italian otorhinolaryngological units. Data regarding indications and surgical procedures were gathered using a predesigned questionnaire and elaborated with analysis of variance, taking P value <.05 as the threshold for statistical significance. Results Over the 4‐year study period, the incidence of the analyzed interventions did not significantly change ( P value >.05), with adenotonsillectomy comprising the most commonly performed (64.1%). No significant variations in the indications for these operations were observed, except for adenotonsillectomy in children having 5 or more feverish episodes in the preceding year without nasal obstruction (decreased: P =. 010). The coexistence of feverish episodes and nasal obstruction was the most frequent surgical indication (65.2%). We also found a high preoperative incidence of middle ear inflammations (43.3%), recovered or improved persistently in 88.5% of the cases after surgery. Conclusion Italian guidelines were not implemented by ENT units involved in the survey; in most cases the indications for adeno‐tonsillectomy are based on the overall clinical presentation rather than on a single symptom. The need to review the Italian guidelines is evident.