The role of tonsillectomy in the Periodic Fever, Aphthous stomatitis, Pharyngitis and cervical Adenitis syndrome; a literature review

BMC Ear, Nose, and Throat Disorders
Jostein Førsvoll, Knut Øymar

Abstract

Tonsillectomy (TE) or adenotonsillectomy (ATE) may have a beneficial effect on the clinical course in children with the Periodic Fever, Aphthous stomatitis, Pharyngitis and cervical Adenitis (PFAPA) syndrome. However, an immunological reason for this effect remains unknown. This literature review summarizes the current knowledge of the effect of TE or ATE in the PFAPA syndrome. A search of PubMed, Medline, EMBASE and Cochrane was conducted for papers written in English dated from 1 January 1987 to 31 December 2016. The search included all studies reporting outcomes after TE or ATE from children aged 0 to 18 years with PFAPA. Two randomized controlled trials reported significantly faster resolution of febrile episodes after TE or ATE in children with PFAPA compared to controls (non-surgery groups). We identified 28 case series including 555 children with PFAPA. The diagnosis was set prospectively before surgery in 440 children and retrospectively after surgery in 115 of the children. TE or ATE had a curative effect in 509 of the 555 children with PFAPA (92%), but few studies were of high quality. TE or ATE may have a curative effect on children with PFAPA, but the evidence is of moderate quality. Further high-quality randomized ...Continue Reading

References

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Citations

Jun 25, 2020·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Fuat BulutAyse Sezim Safak
Feb 27, 2021·Clinical Immunology : the Official Journal of the Clinical Immunology Society·Irene LuuLori Broderick
Sep 9, 2020·International Journal of Pediatric Otorhinolaryngology·Ali Karayağmurlu, İsmail Aytaç
Aug 26, 2021·World Journal of Otorhinolaryngology - Head and Neck Surgery·Alicia WangGreg R Licameli
Dec 14, 2021·Frontiers in Pediatrics·Tatjana WelzelJasmin B Kuemmerle-Deschner

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