Giovanni Motta, Sergio Motta, Pasquale Cassano, Salvatore Conticello, Massimo Ferretti, Bruno Galletti, Aldo Garozzo, Gennaro Larotonda, Nicola Mansi, Emilio Mevio, Gaetano Motta, Giuseppe Quaremba, Agostino Serra, Vincenzo Tarantino, Paolo Tavormina, Claudio Vicini, Maurizio Giovanni Vigili, Domenico Testa
{"title":"腺扁桃体手术指南对意大利耳鼻喉科医生临床行为的影响。","authors":"Giovanni Motta, Sergio Motta, Pasquale Cassano, Salvatore Conticello, Massimo Ferretti, Bruno Galletti, Aldo Garozzo, Gennaro Larotonda, Nicola Mansi, Emilio Mevio, Gaetano Motta, Giuseppe Quaremba, Agostino Serra, Vincenzo Tarantino, Paolo Tavormina, Claudio Vicini, Maurizio Giovanni Vigili, Domenico Testa","doi":"10.1186/1472-6815-13-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Unlabelled: </strong></p><p><strong>Background: </strong>Several guidelines on adeno-tonsillar disease have been proposed in recent years and some discrepancies in relation both to clinical manifestations and indications for surgical treatment have emerged. The aim of the study was to verify what influence (adeno)-tonsillectomy guidelines have had on the clinical behaviour of ENT specialists in Italy. Our study is a retrospective and multi-centre case series with chart review.</p><p><strong>Methods: </strong>The survey involved 14,770 children, aged between the ages of 2 and 11, who had undergone adeno-tonsillar surgery between 2002 and 2008 in fourteen Italian tertiary and secondary referral centres. Anova test was used for the statistical analysis, assuming p < 0.05 as the minimum statistical significance value.</p><p><strong>Results: </strong>The frequency of adeno-tonsillar surgeries did not change significantly (p>0.05) during the study period and following the Italian policy document publication. Overall, adeno-tonsillectomy was the most frequent intervention (64.1%), followed by adenoidectomy (31.1%) and tonsillectomy (4.8%). The indications for surgery did not change significantly for each of the operations (p>0.05), with the exception of adeno-tonsillectomy in case of feverish episodes due to acute recurrent tonsillitis ≥ 5 without nasal obstruction (decreased p= 0.010) , even when the feverish episodes due to acute recurrent tonsillitis were < 5 over the last year. Nasal obstruction was associated with feverish episodes due to acute recurrent tonsillitis in 65.2% of operated cases, while otitis media had been diagnosed in 43.3% of the patients studied.</p><p><strong>Conclusions: </strong>The recommendations first developed in Italy in a 2003 policy document and then resumed in guidelines in 2008, were not implemented by ENT units involved in the survey. The study highlights the fact that the indications for adeno-tonsillar operations are based on the overall clinical presentation (comorbidity) rather than on a single symptom. Guidelines are necessary to give coherent recommendations based on both the findings obtained through randomized controlled trials and the data collected from observational studies.</p>","PeriodicalId":39843,"journal":{"name":"BMC Ear, Nose and Throat Disorders","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2013-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1472-6815-13-1","citationCount":"20","resultStr":"{\"title\":\"Effects of guidelines on adeno-tonsillar surgery on the clinical behaviour of otorhinolaryngologists in Italy.\",\"authors\":\"Giovanni Motta, Sergio Motta, Pasquale Cassano, Salvatore Conticello, Massimo Ferretti, Bruno Galletti, Aldo Garozzo, Gennaro Larotonda, Nicola Mansi, Emilio Mevio, Gaetano Motta, Giuseppe Quaremba, Agostino Serra, Vincenzo Tarantino, Paolo Tavormina, Claudio Vicini, Maurizio Giovanni Vigili, Domenico Testa\",\"doi\":\"10.1186/1472-6815-13-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Unlabelled: </strong></p><p><strong>Background: </strong>Several guidelines on adeno-tonsillar disease have been proposed in recent years and some discrepancies in relation both to clinical manifestations and indications for surgical treatment have emerged. The aim of the study was to verify what influence (adeno)-tonsillectomy guidelines have had on the clinical behaviour of ENT specialists in Italy. Our study is a retrospective and multi-centre case series with chart review.</p><p><strong>Methods: </strong>The survey involved 14,770 children, aged between the ages of 2 and 11, who had undergone adeno-tonsillar surgery between 2002 and 2008 in fourteen Italian tertiary and secondary referral centres. Anova test was used for the statistical analysis, assuming p < 0.05 as the minimum statistical significance value.</p><p><strong>Results: </strong>The frequency of adeno-tonsillar surgeries did not change significantly (p>0.05) during the study period and following the Italian policy document publication. Overall, adeno-tonsillectomy was the most frequent intervention (64.1%), followed by adenoidectomy (31.1%) and tonsillectomy (4.8%). The indications for surgery did not change significantly for each of the operations (p>0.05), with the exception of adeno-tonsillectomy in case of feverish episodes due to acute recurrent tonsillitis ≥ 5 without nasal obstruction (decreased p= 0.010) , even when the feverish episodes due to acute recurrent tonsillitis were < 5 over the last year. Nasal obstruction was associated with feverish episodes due to acute recurrent tonsillitis in 65.2% of operated cases, while otitis media had been diagnosed in 43.3% of the patients studied.</p><p><strong>Conclusions: </strong>The recommendations first developed in Italy in a 2003 policy document and then resumed in guidelines in 2008, were not implemented by ENT units involved in the survey. The study highlights the fact that the indications for adeno-tonsillar operations are based on the overall clinical presentation (comorbidity) rather than on a single symptom. Guidelines are necessary to give coherent recommendations based on both the findings obtained through randomized controlled trials and the data collected from observational studies.</p>\",\"PeriodicalId\":39843,\"journal\":{\"name\":\"BMC Ear, Nose and Throat Disorders\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2013-01-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1186/1472-6815-13-1\",\"citationCount\":\"20\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Ear, Nose and Throat Disorders\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/1472-6815-13-1\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Ear, Nose and Throat Disorders","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/1472-6815-13-1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Effects of guidelines on adeno-tonsillar surgery on the clinical behaviour of otorhinolaryngologists in Italy.
Unlabelled:
Background: Several guidelines on adeno-tonsillar disease have been proposed in recent years and some discrepancies in relation both to clinical manifestations and indications for surgical treatment have emerged. The aim of the study was to verify what influence (adeno)-tonsillectomy guidelines have had on the clinical behaviour of ENT specialists in Italy. Our study is a retrospective and multi-centre case series with chart review.
Methods: The survey involved 14,770 children, aged between the ages of 2 and 11, who had undergone adeno-tonsillar surgery between 2002 and 2008 in fourteen Italian tertiary and secondary referral centres. Anova test was used for the statistical analysis, assuming p < 0.05 as the minimum statistical significance value.
Results: The frequency of adeno-tonsillar surgeries did not change significantly (p>0.05) during the study period and following the Italian policy document publication. Overall, adeno-tonsillectomy was the most frequent intervention (64.1%), followed by adenoidectomy (31.1%) and tonsillectomy (4.8%). The indications for surgery did not change significantly for each of the operations (p>0.05), with the exception of adeno-tonsillectomy in case of feverish episodes due to acute recurrent tonsillitis ≥ 5 without nasal obstruction (decreased p= 0.010) , even when the feverish episodes due to acute recurrent tonsillitis were < 5 over the last year. Nasal obstruction was associated with feverish episodes due to acute recurrent tonsillitis in 65.2% of operated cases, while otitis media had been diagnosed in 43.3% of the patients studied.
Conclusions: The recommendations first developed in Italy in a 2003 policy document and then resumed in guidelines in 2008, were not implemented by ENT units involved in the survey. The study highlights the fact that the indications for adeno-tonsillar operations are based on the overall clinical presentation (comorbidity) rather than on a single symptom. Guidelines are necessary to give coherent recommendations based on both the findings obtained through randomized controlled trials and the data collected from observational studies.
期刊介绍:
BMC Ear, Nose and Throat Disorders is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of ear, nose and throat disorders, as well as related molecular genetics, pathophysiology, and epidemiology. BMC Ear, Nose and Throat Disorders (ISSN 1472-6815) is indexed/tracked/covered by PubMed, CAS, EMBASE, Scopus and Google Scholar.