The efficacy of tonsillectomy in the management of PFAPA syndrome: a systematic review and meta-analysis.
Tonsillectomy greatly increases complete remission of PFAPA syndrome versus conservative treatment.
The efficacy of tonsillectomy in the management of PFAPA syndrome: a systematic review and meta-analysis.
To evaluate tonsillectomy's effectiveness in treating PFAPA syndrome through a systematic review and meta-analysis, providing evidence to guide clinical decisions and improve patient outcomes.
A meta-analysis of randomized controlled trials comparing surgical vs. conservative treatment was conducted to evaluate the postoperative complete remission rate, duration of fever, and frequency of fever episodes.
tonsillectomy far more likely to achieve complete remission than conservative care
Three randomized controlled trials (81 patients) met the inclusion criteria.
The pooled mean difference in fever duration was -3.15 days (95% CI: -6.78 to 0.49, P = 0.090), which was not statistically significant, with substantial heterogeneity (I² = 68.5%).
Surgery significantly reduced fever episode frequency (MD = -0.41 episodes/person-month, 95% CI: -0.66 to -0.15, P = 0.002, I² = 0%).
No postoperative complications were reported.
This meta-analysis suggests that tonsillectomy can provide significant benefits for children with PFAPA, particularly in achieving complete remission and reducing episode frequency.
However, evidence on fever duration remains inconclusive, whereas the reduction in episode frequency was statistically robust. Given the small number of included studies, these results should be considered hypothesis-generating.
Future large-scale, well-designed RCTs are needed to confirm these findings.