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Updated: Dec 8, 2025

CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
[Sore throat as indication for tonsillectomy before and after implementation of the German guideline for tonsillitis
J P Windfuhr1, C Schmuker2, C Günster2
1Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Kliniken Maria Hilf, Viersener Str. 450, 41063, Mönchengladbach, Deutschland. jochen.windfuhr@mariahilf.de.
Background:
Tonsillectomy is a reasonable indication in the management of sore throat not responding to antibiotic treatment. This longitudinal patient-level study was conducted to estimate the impact of the German guideline for the management of tonsillitis which was published in 2015.
Methods:
Data of inpatient and outpatient healthcare were retrieved from a database provided by one of the largest German health insurance companies (i.e., Allgemeine Ortskrankenkassen). Procedures for the management of chronic tonsillitis (code: J35.0) between 2012 and 2018 were identified by operation codes (5-281.0; 5‑282.0). Primary care data concerning sore throat were identified by ICD-10 codes (J02; J03; J35.0) including antibiotic prescribing by associated data of the anatomic-therapeutic-chemical classification.
Results:
A total of 109,895 cases were eligible for analysis. The annual number of procedures had decreased by 50.3% within the study period. The continuous decrease was emphasized after 2015. The strongest decrease was registered in children (<10 years; -65.7%). Every second patients had received conservative treatment at the most in only one preoperative quarter.
Conclusions:
The impact of the German guideline on the management of sore throat on the annual number of tonsillectomies and common medical practice was limited. Antibiotic treatment appears not to play a major role when tonsillectomy is indicated.
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