Objective:

To evaluate tonsillectomy's effectiveness in treating PFAPA syndrome through a systematic review and meta-analysis.

Approach:

• Data Source: The PubMed, Cochrane Library, and Google Scholar databases were searched for relevant studies.
• Methods: A meta-analysis of randomized controlled trials comparing surgical vs. conservative treatment was conducted.

Key Findings:

• Three randomized controlled trials (81 patients) met the inclusion criteria.
• Tonsillectomy significantly improved postoperative complete remission rates (pooled OR = 42.21, 95% CI: 9.34–190.74, P < 0.0001).
• The pooled mean difference in fever duration was −3.15 days (95% CI: −6.78 to 0.49), which was not statistically significant.
• Surgery significantly reduced fever episode frequency (MD = −0.41 episodes/person-month, 95% CI: −0.66 to −0.15, P = 0.002).
• No postoperative complications were reported.

Interpretation:

Tonsillectomy can provide significant benefits for children with PFAPA, particularly in achieving complete remission and reducing episode frequency.

Limitations:

• Small number of included studies.
• Evidence on fever duration remains inconclusive.

Conclusion:

Future large-scale, well-designed RCTs are needed to confirm these findings.