A Prospective Study on Acute Tonsillitis & its Risk Factors and Management Outcomes: Prospective study

Abstract

Background: Tonsillitis is among the commonest ENT consultations, yet local data on modifiable risk factors and comparative outcomes of medical versus surgical management remain limited. Objective: To identify risk factors associated with acute tonsillitis and compare short term outcomes of conservative treatment versus tonsillectomy. Methods: Prospective observational study of 45 patients (10–50 y) at a tertiary ENT clinic. Baseline demographics and seven predefined risk factors were collected. Management modality was chosen by shared decision making. Outcomes (resolution of symptoms, recurrence, adverse events) were assessed at 3 months. Results: Mean age 22.4 y; 53 % male. The three most prevalent risk factors were recurrent URTIs (62 %), smoking exposure (47 %), and allergic rhinitis (35 %). At 3 months, complete symptom free status was achieved in 91 % of the tonsillectomy group versus 59 % of the conservative group (p = 0.03). Multivariable logistic regression identified recurrent URTIs (OR 3.8, 95 % CI 1.1–13.1) and smoking exposure (OR 3.2, 95 % CI 0.9–11.0) as independent predictors of poor response to conservative therapy. Conclusion: Recurrent infections and tobacco exposure are key modifiable risks for tonsillitis. Tonsillectomy offered superior short term relief in patients with ≥ 3 risk factors or recurrent episodes.