Skip to main content
SpringerLink
Log in

Preoperative serum pattern analysis to predict the outcome of tonsillectomy in adults with chronic tonsillitis

  • Miscellaneous
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The method of classification and tree analysis (CART) was used to predict the outcome of tonsillectomy for chronic tonsillitis (CHT) analyzing patterns of serological markers. In a prospective case study of 24 adult patients with CHT in comparison to 24 patients with acute peritonsillar abscess (PTA) blood samples were assessed 1 day before (T-1) and 3 days after tonsillectomy. Outcome 6 months later (T180) was documented using the Glasgow Benefit Inventory (GBI) and the Specific Benefits from Tonsillectomy Inventory (SBTI). In comparison to PTA, patients with CHT were at best classified by C-reactive protein with a cut-off value of <16.735 mg/dl. For CHT, immunoglobulin E ≤ 144.65 kU/l and the combination of monocytes ≤0.565 Gpt/l plus leucocytes >5.855 Gpt/l at T-1 were the best classificators for higher SBTI overall score and symptom score symptom score, respectively, at T180. A higher benefit subscore at T180 was associated to γ-globulin >15.85 % plus α2-globulin >8.950 % at T-1. The best classificator for better GBI overall score at T180 was an ASL titer >169.0 IU/ml or the combination of an ASL titer ≤169.0 IU/ml with lymphocytes ≤2.195 Gpt/l. Lymphocytes ≤2.195 Gpt/l were associated with higher GBI general subscore. Leukocytes ≤6.780 Gpt/l were related to higher GBI social support subscore. The combination of immunoglobulin A >1.360 g/l with procalcitonin level >0.058 ng/ml was the best combination to classify for higher physical health score. Instead of looking on isolated serologic markers, CART of multiple parameters seems to be more effective to predict the outcome of tonsillectomy for CHT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Burton MJ, Glasziou PP (2009) Tonsillectomy or adeno-tonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev CD001802

  2. Paradise JL, Bluestone CD, Bachman RZ et al (1984) Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials. New Engl J Med 310:674–683

    Article  CAS  PubMed  Google Scholar 

  3. SIGN (2010) Management of sore throat and indications for tonsillectomy. A national clinical guideline. SIGN publication, Edinburgh

    Google Scholar 

  4. Bohne S, Siggel R, Sachse S et al (2013) Clinical significance and diagnostic usefulness of serologic markers for improvement of outcome of tonsillectomy in adults with chronic tonsillitis. J Negat Results Biomed 12:11

    Article  PubMed Central  PubMed  Google Scholar 

  5. Laing MR, McKerrow WS (1991) Adult tonsillectomy. Clin Otolaryngol Allied Sci 1991(16):21–24

    Article  Google Scholar 

  6. Baumann I, Kucheida H, Blumenstock G, Zalaman IM, Maassen MM, Plinkert PK (2006) Benefit from tonsillectomy in adult patients with chronic tonsillitis. Eur Arch Otorhinolaryngol 263:556–559

    Article  PubMed  Google Scholar 

  7. Alho OP, Koivunen P, Penna T, Teppo H, Koskela M, Luotonen J (2007) Tonsillectomy versus watchful waiting in recurrent streptococcal pharyngitis in adults: randomised controlled trial. BMJ 334:939

    Article  PubMed Central  PubMed  Google Scholar 

  8. Windfuhr JP, Chen YS, Remmert S (2005) Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients. Otolaryngol Head Neck Surg 132:281–286

    Article  CAS  PubMed  Google Scholar 

  9. Koskenkorva T, Koivunen P, Penna T, Teppo H, Alho OP (2009) Factors affecting quality-of-life impact of adult tonsillectomy. J Laryngol Otol 123:1010–1014

    Article  CAS  PubMed  Google Scholar 

  10. Poller K, Volk GF, Wittekindt C, Meissner W, Guntinas-Lichius O (2011) Estimation of postoperative pain after tonsillectomy in adults using QUIPS: an instrument to improve postoperative pain management. Laryngorhinootol 90:82–89

    Article  CAS  Google Scholar 

  11. Lemon SC, Roy J, Clark MA, Friedmann PD, Rakowski W (2003) Classification and regression tree analysis in public health: methodological review and comparison with logistic regression. Ann Behav Med 26:172–181

    Article  PubMed  Google Scholar 

  12. Ebell MH, Afonso AM, Geocadin RG, for the American Heart Association’s Get With the Guidelines-Resuscitation (2013) Prediction of survival to discharge following cardiopulmonary resuscitation using classification and regression trees. Crit Care Med 41:2688–2697

    Article  PubMed  Google Scholar 

  13. Bhattacharyya N, Kepnes LJ, Shapiro J (2001) Efficacy and quality-of-life impact of adult tonsillectomy. Arch Otolaryngol Head Neck Surg 127:1347–1350

    Article  CAS  PubMed  Google Scholar 

  14. Kasenomm P, Piirsoo A, Kull M, Kull M Jr, Mikelsaar M (2005) Selection of indicators for tonsillectomy in adults with recurrent tonsillitis. BMC Ear Nose Throat Disord 5:7

    Article  PubMed Central  PubMed  Google Scholar 

  15. Zautner AE, Krause M, Stropahl G et al (2010) Intracellular persisting Staphylococcus aureus is the major pathogen in recurrent tonsillitis. PLoS One 5:e9452

    Article  PubMed Central  PubMed  Google Scholar 

  16. Nave H, Gebert A, Pabst R (2001) Morphology and immunology of the human palatine tonsil. Anat Embryol 204:367–373

    Article  CAS  PubMed  Google Scholar 

  17. Brandtzaeg P (2003) Immunology of tonsils and adenoids: everything the ENT surgeon needs to know. Int J Ped Otorhinolaryngol 67(Suppl 1):S69–S76

    Article  Google Scholar 

  18. Weyrich AS, Lindemann S, Zimmerman GA (2003) The evolving role of platelets in inflammation. J Thromb Haemost 1:1897–1905

    Article  CAS  PubMed  Google Scholar 

  19. Wagner DD, Burger PC (2003) Platelets in inflammation and thrombosis. Arterioscler Thromb Vasc Biol 23:2131–2137

    Article  CAS  PubMed  Google Scholar 

  20. Yeaman MR (2010) Platelets in defense against bacterial pathogens. Cell Mol Life Sci 67:525–544

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Clemetson KJ (2010) Platelets and pathogens. Cell Mol Life Sci 67:495–498

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors indicate that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, 07740, Jena, Germany

    Katharina Geißler, Silvia Bohne, Robert Siggel & Orlando Guntinas-Lichius

  2. Institute of Medical Microbiology, Jena University Hospital, Jena, Germany

    Svea Sachse & Eberhard Straube

  3. Institute of Clinical Chemistry and Laboratory Diagnostics, Jena University Hospital, Jena, Germany

    Michael Kiehntopf

  4. Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany

    Michael Bauer

Authors
  1. Katharina Geißler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Silvia Bohne
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert Siggel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Svea Sachse
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael Kiehntopf
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael Bauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eberhard Straube
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Orlando Guntinas-Lichius
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Orlando Guntinas-Lichius.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Geißler, K., Bohne, S., Siggel, R. et al. Preoperative serum pattern analysis to predict the outcome of tonsillectomy in adults with chronic tonsillitis. Eur Arch Otorhinolaryngol 271, 2803–2811 (2014). https://doi.org/10.1007/s00405-014-3084-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-014-3084-5

Keywords

Search

Navigation