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Published on: November 6, 2019
General practitioners' versus consultants' perspective on indications for paediatric tonsillectomy: current trends
J Manickavasagam1, S Ali, M S Quraishi
1Otorhinolaryngology, Head and neck surgery, Doncaster Royal Infirmary, UK. jaiganeshkalpana@yahoo.co.uk
Insights
General practitioners (GPs) and ENT surgeons differ on when to recommend tonsillectomy for children. Improved dissemination of standardized guidelines is needed to align these views, particularly for conditions like glue ear and snoring.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- General Practice
Background:
- Tonsillectomy is a common pediatric surgical procedure.
- Understanding referral criteria is crucial for appropriate patient management.
- Discrepancies may exist between general practitioners and specialist surgeons regarding indications.
Purpose of the Study:
- To identify factors general practitioners (GPs) consider important for pediatric tonsillectomy referrals.
- To compare GP perspectives with those of consultant Ear, Nose, and Throat (ENT) surgeons.
- To assess alignment with current indications for pediatric tonsillectomy.
Main Methods:
- A web-based questionnaire study was conducted.
- Data collected from 141 general practitioners and 146 consultant ENT surgeons.
Main Results:
- A significantly lower percentage of GPs (65%) considered tonsillectomy useful compared to ENT surgeons (98%) (p < 0.001).
- GP views on tonsillectomy usefulness differed significantly from previous findings in 1994 (p < 0.001).
- Key areas of disagreement included indications for 'glue ear', recurrent ear infections, and snoring.
Conclusions:
- While general awareness of tonsillectomy indications is good, significant differences exist between GPs and ENT surgeons.
- Specific conditions like 'glue ear', recurrent ear infections, and snoring highlight these discrepancies.
- Effective dissemination of standardized tonsillectomy indications to GPs is recommended to improve consistency.
Aims:
We undertook a study to ascertain what factors general practitioners consider important when referring children for tonsillectomy, and to compare these views with those of consultant ENT surgeons.
Methods:
Web-based questionnaire study.
Results:
A total of 141 general practitioners and 146 consultants responded. Tonsillectomy in children was regarded as a useful operation by 65 per cent of general practitioners and 98 per cent of consultant ENT surgeons. This difference was statistically significant (p < 0.001, chi-square test). In 1994, Donnelly et al. found that 92 per cent of general practitioners considered tonsillectomy in children a useful operation; our results were significantly different (p < 0.001, chi-square test).
Conclusions:
There is a good level of awareness and agreement on the currently accepted indications for paediatric tonsillectomy in both groups. However, there were important areas of difference between the two groups with regard to 'glue ear', recurrent ear infections and snoring. Standardised indications for tonsillectomy should be effectively disseminated to general practitioners.
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