{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T16:48:04Z","timestamp":1769014084728,"version":"3.49.0"},"reference-count":19,"publisher":"Royal College of Surgeons of England","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec><jats:title>INTRODUCTION<\/jats:title><jats:p> Sore throat and tonsillitis place a significant burden on the National Health Service. National guideline criteria for gauging the severity of sore throat and tonsillitis have reduced the number of tonsillectomies performed, which is thought to have increased the rate of tonsil-related infections. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p> Data was extracted from the prospective Patient Episode Database of Wales and analysed to determine the annual number of tonsillectomies for recurrent tonsillitis, adjusted for population changes. Admissions to acute hospitals for tonsillitis, peritonsillar abscess and deep neck space abscesses were also examined. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> Between 1999 and 2014, hospital admissions for tonsillitis rose three-fold (r=0.968), while admissions for peritonsillar abscess rose by 48% (r=0.857) and retro or parapharyngeal abscess admissions also increased (r=0.709). In contrast, the number of tonsillectomies per 100,000 population gradually decreased (r=-0.16). There was a positive correlation between the incidence of tonsillitis and admissions for peritonsillar abscess (adjusted r<jats:sup>2<\/jats:sup> 0.631; p=0.015) and retropharyngeal abscess (adjusted r<jats:sup>2<\/jats:sup> 0.442; p=0.00254). There was a statistically significant negative correlation between the incidence of tonsillitis and the number of tonsillectomies performed (adjusted r<jats:sup>2<\/jats:sup>=-0.07; p=0.0235). <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p> The significant rise in tonsillitis in Wales raises the question as to whether we should revisit the criteria for tonsillectomy. The perceived cost saving from limiting certain procedures should not prevent healthcare policymakers from considering all other evidence. The rise in peritonsillar, retropharyngeal and parapharyngeal abscess is alarming, as they are associated with significant morbidity and mortality. <\/jats:p><\/jats:sec>","DOI":"10.1308\/rcsann.2016.0261","type":"journal-article","created":{"date-parts":[[2016,8,11]],"date-time":"2016-08-11T15:41:40Z","timestamp":1470930100000},"page":"31-36","source":"Crossref","is-referenced-by-count":13,"title":["Serious tonsil infections versus tonsillectomy rates in Wales: A 15-year analysis"],"prefix":"10.1308","volume":"99","author":[{"given":"D","family":"Yap","sequence":"first","affiliation":[{"name":"Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, Wales"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AS","family":"Harris","sequence":"additional","affiliation":[{"name":"Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, Wales"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Clarke","sequence":"additional","affiliation":[{"name":"Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, Wales"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"171","reference":[{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811422011"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.12968\/hmed.2009.70.6.344"},{"key":"bib4","volume-title":"Management of Sore Throat and Indications for Tonsillectomy. A National Clinical Guideline","author":"Scottish Intercollegiate Guidelines Network","year":"1990"},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1308\/003588414X13946184900363"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-013-2345-z"},{"key":"bib8","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(97)70345-0"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-007-0524-5"},{"key":"bib10","volume":"10","author":"Wang YP","year":"2015","journal-title":"PLoS ONE"},{"key":"bib11","doi-asserted-by":"publisher","DOI":"10.1111\/j.0307-7772.2004.00771.x"},{"key":"bib12","volume-title":"Indications for Tonsillectomy and Adenotonsillectomy In Children. A joint Position paper of the Paediatrics & Child Health Division of The Royal Australasian College of Physicians and The Australian Society of Otolaryngology Head and Neck Surgery","author":"Royal Australasian College of Physicians, Australian Society of Otolaryngology Head and Neck Surgery","year":"2008"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.1177\/0194599810389949"},{"key":"bib15","volume-title":"Clinical Practice Guidelines. Management of Sore Throat","author":"Ministry of Health Malaysia, Academy of Medicine Malaysia","year":"2003"},{"key":"bib16","first-page":"CD001802","author":"Burton MJ","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"bib17","doi-asserted-by":"publisher","DOI":"10.3310\/hta14100"},{"key":"bib18","unstructured":"Department of Health. Single-use instruments for tonsil and adenoid surgery. London: Department of Health, 2001."},{"key":"bib20","volume-title":"Summary of SEAC Committee Meeting 28 November 2000","author":"Spongiform Encephalopathy Advisory Committee","year":"2000"},{"key":"bib21","volume-title":"Risk assessment for transmission of vCJD via surgical instruments: A modelling approach and numerical scenarios","author":"Department of Health","year":"2001"},{"key":"bib22","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdr054"},{"key":"bib23","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2003.12.043"}],"container-title":["The Annals of The Royal College of Surgeons of England"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/pdf\/10.1308\/rcsann.2016.0261","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T10:23:27Z","timestamp":1684146207000},"score":1,"resource":{"primary":{"URL":"https:\/\/publishing.rcseng.ac.uk\/doi\/10.1308\/rcsann.2016.0261"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,1]]}},"alternative-id":["10.1308\/rcsann.2016.0261"],"URL":"https:\/\/doi.org\/10.1308\/rcsann.2016.0261","relation":{},"ISSN":["0035-8843","1478-7083"],"issn-type":[{"value":"0035-8843","type":"print"},{"value":"1478-7083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1]]}}}