Recurrent Tonsillitis and Tonsillectomy
Please note: Suspected tonsillar malignancy is an unequivocal indication for tonsillectomy, and not subject to the criteria below.
Please confirm that the patient meets the criteria for ONE of the sections below:
Section a
The patient has recurrent sore throat due to acute tonsillitis and the following documented evidence applies:
- SEVEN or more documented, clinically significant, adequately treated sore throats in the preceding ONE year OR
- FIVE or more episodes in each of the preceding TWO years OR
- THREE or more episodes in each the preceding THREE years
Please provide the dates of the recorded diagnosed episodes of clinically significant sore throat/tonsillitis
If the patient has not met any of the diagnosis frequency criteria above, please indicate which of the following alternative eligibility criteria are met:
Section b
- Following specialist assessment, the patient has acute and chronic renal disease resulting from acute bacterial tonsillitis AND/OR
- Following specialist assessment, this intervention is part of the treatment of severe guttate psoriasis AND/OR
- Following specialist assessment, the patient has metabolic disorders where periods of reduced oral intake could be dangerous to their health AND/OR
- Following specialist assessment, the patient has Periodic fever, Aphthous stomatitis, Pharyngitis, Cervical adenitis (PFAPA) AND/OR
- Following specialist assessment, the patient has severe immune deficiency that would make episodes of recurrent tonsillitis dangerous
Section c
- Patient has a diagnosis of obstructive sleep apnoea associated with tonsillar enlargement,
- supported by a sleep study or other accepted method of diagnosis
Section d
- Patient has had one episode of peri-tonsillar abscess (recurrent quinsy)
Section e
Patient has tonsillar enlargement causing acute upper airway obstruction requiring emergency surgery
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