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1000 Titel
  • Tonsillectomy versus tonsillotomy for recurrent acute tonsillitis in children and adults (TOTO): study protocol for a randomized non-inferiority trial
1000 Autor/in
  1. Guntinas-Lichius, Orlando |
  2. Geißler, Katharina |
  3. Asendorf, Thomas |
  4. Tostmann, Ralf |
  5. Löhler, Jan |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-07-22
1000 Erschienen in
1000 Quellenangabe
  • 22(1):479
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s13063-021-05434-y |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8296750/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Background!#!Tonsillectomy is one of the most frequently performed surgeries in children and young adults worldwide. For decades, tonsillectomy was the surgical treatment of choice for recurrent acute tonsillitis. Tonsillotomy was used in some countries as an alternative to tonsillectomy only for the treatment of obstructive sleep apnea in young children. In recent years, an increase of tonsillotomy also to treat recurrent acute tonsillitis can be observed. Therefore, the German Institute for Quality and Efficiency in Health Care (IQWiG) was commissioned by the Federal Joint Committee (G-BA) to investigate whether tonsillotomy offers advantages compared to tonsillectomy. The meta-analysis of the IQWiG including studies until 2016 revealed that the long-term benefits and harms of tonsillotomy compared to tonsillectomy are unclear. Consequently, the G-BA performed a European call for a clinical trial. A consortium of the German Professional Association of ENT-surgeons (BVHNO), the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), and the Jena University Hospital were finally selected to perform the TOTO study.!##!Methods!#!TOTO is a multicenter, 1:1 two-arm, randomized non-blinded non-inferiority trial. Four hundred fifty-four patients ≥ 3 years of age will be randomly allocated to undergo either tonsillotomy or tonsillectomy as surgical treatment of recurrent acute tonsillitis. All participants will be followed up for a total of 24 months. The primary outcome is the number of sore throat days experienced over the 24-month follow-up.!##!Discussion!#!TOTO is designed to evaluate the effectiveness and efficiency of tonsillectomy versus tonsillectomy for the management of patients with recurrent acute tonsillitis. Tonsil disease and surgery have a major impact on preschool and school children as well as on economically active young adults, with individual and societal costs through loss of school visits, earnings, and productivity. If tonsillotomy is at least as effective as tonsillectomy but with reduced morbidity, this would reduce costs to the healthcare system and society.!##!Trial registration!#!German Clinical Trials Register DRKS00020823 . Registered on 04 September 2020.
1000 Sacherschließung
lokal Tonsillitis/surgery [MeSH]
lokal Randomized controlled trial
lokal Study Protocol
lokal Tonsillectomy
lokal Humans [MeSH]
lokal Quinolinium Compounds [MeSH]
lokal Tonsillectomy/adverse effects [MeSH]
lokal Multicenter Studies as Topic [MeSH]
lokal Thiazoles [MeSH]
lokal Sleep Apnea, Obstructive [MeSH]
lokal Tonsillotomy
lokal Randomized Controlled Trials as Topic [MeSH]
lokal Tonsillitis
lokal Young Adult [MeSH]
lokal Pharyngitis [MeSH]
lokal Sore throat
lokal Surgery
lokal Tonsillitis/diagnosis [MeSH]
lokal Child [MeSH]
lokal Meta-Analysis as Topic [MeSH]
lokal Child, Preschool [MeSH]
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0001-9671-0784|https://frl.publisso.de/adhoc/uri/R2Vpw59sZXIsIEthdGhhcmluYQ==|https://frl.publisso.de/adhoc/uri/QXNlbmRvcmYsIFRob21hcw==|https://frl.publisso.de/adhoc/uri/VG9zdG1hbm4sIFJhbGY=|https://frl.publisso.de/adhoc/uri/TMO2aGxlciwgSmFu
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1000 Erstellt am 2023-11-16T14:43:56.530+0100
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