Overview
Tonsillitis is an inflammation of the tonsils, commonly caused by viral or bacterial infections, leading to symptoms such as sore throat, fever, and swollen lymph nodes. It affects individuals of all ages but is particularly prevalent in children 19.Diagnosis
Management
Special Populations
Key Recommendations
References
Showing 100 most recent of 748 indexed papers.
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Effect of otolaryngology analgesia guidelines on opioid prescribing in pediatric tonsillectomy. International journal of pediatric otorhinolaryngology 2025. link 6 Koutrouveli E, Panagiotopoulou A, Sfakiotaki R, Boviatsi D, Sofokleous V, Chountala A et al.. Pediatric tonsillar pathology: a comprehensive ultrasonographic approach. Pediatric radiology 2025. link 7 Heinz N, Jensen MM, Bernth-Andersen S, Kiær EK, Jensen RG. Tonsillotomy by monopolar diathermy as a new procedure in Greenland: a feasibility study. International journal of circumpolar health 2025. link 8 Sutton SR, Duckett KA, Nietert PJ, Ford ME, Pecha PP. The impact of social determinants of health on pediatric tonsillectomy. International journal of pediatric otorhinolaryngology 2025. link 9 Gümüş M, Teklu SW, Sezgin A. Optimal intervention design for tonsillitis transmission via compartmental modeling with stability analysis and control strategies. Scientific reports 2025. link 10 Hao S, Yuan Y, Fang X, Ye W. Multi-target pharmacological mechanisms of Iris tectorum Maxim. (CSG) against tonsillitis and dyspepsia: A network pharmacology approach. Medicine 2025. link 11 Al-Alawneh M, Al Alimi W, Barakat A. Prevalence of electronic smoking exposure and tonsillectomy surgery in children. International journal of pediatric otorhinolaryngology 2025. link 12 Shiner YA, Caplan S, Doweck I. Actinomyces findings in tonsillectomy specimens- comparison between adults and pediatrics populations. 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 2025. link 13 Toppenberg AGL, Plaat RE, Schwandt LQ. Transoral Robotic Surgery in Chronic Lingual Tonsillitis: An Observational Cohort Study. Head & neck 2025. link 14 Li J, Tu B, Mao X, Zhao Y, Du Q, Wang F et al.. First report on a foodborne outbreak of Streptococcus dysgalactiae Subsp. equisimilis in China. Journal of health, population, and nutrition 2025. link 15 Wong Chung JERE, van den Hout WB, van Helmond N, van Benthem PPG, Blom HM. Long-Term Efficacy and Cost-Effectiveness of Laser Tonsillotomy vs Tonsillectomy: A Secondary Analysis of a Randomized Clinical Trial. JAMA network open 2025. link 16 Abdullah FH, Low YX, Teo R, Azmi MI, Mokhtar MN, Azaharuddin I et al.. Rare case of necrotizing tonsillitis causing severe airway infection in an infant: a case report. Italian journal of pediatrics 2025. link 17 Seidel DU, Bode S, Kostev K. Seasonal variation and demographic characteristics of acute tonsillitis and peritonsillar abscess in ENT practices in Germany (2019-2023). 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 2025. link 18 Han F, Wu F, Ma M. Specific Measures and Benefits of Comprehensive Nursing Model in Clinical Practice for Pediatric Purulent Tonsillitis. Alternative therapies in health and medicine 2025. link 19 Nguyen VTN, Ngo L, Stratton E, Arriola D. Tonsillitis. Primary care 2025. link 20 Hill C, Ah-See K, Moffat H. Piloting of a Decision Aid for Recurrent Tonsillitis. Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 2025. link 21 Semih AK. Tonsillotomy with Coblator or Tonsillectomy? One-Year Postoperative Follow-up Results. American journal of otolaryngology 2025. link 22 Kisser U, Stelter K, Lill C. Total versus subtotal tonsillectomy for recurrent tonsillitis: 5-year follow up of a prospective randomized noninferiority clinical trial. 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 2025. link 23 Virkkunen J, Nokso-Koivisto J, Sakki AJ. Long-term effectiveness of tonsillotomy versus tonsillectomy: A 12-year follow-up study. 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 2025. link 24 Sulibhavi A, Isaacson G. TikTok Tonsils. Ear, nose, & throat journal 2024. link 25 Pylypiv DB, Sharga BM, Rishko OA, Leshak V, Karbovanets E. Relation of Streptococcus Pyogenes tonsillitis isolate to antimicrobial agents and its infection treatment. Wiadomosci lekarskie (Warsaw, Poland : 1960) 2024. link 26 Loh TL, Toh P, Harbhajan Singh TS, Anderson S, Kong K, Ekanayake M et al.. Intracapsular versus extracapsular tonsil surgery: Comparison of postoperative haemorrhage outcomes in the Australasian setting. International journal of pediatric otorhinolaryngology 2024. link 27 Seçilmis Y. Membranous tonsillitis: Aetiology, prevalence and prescribing patterns in patients with upper respiratory tract infection. The National medical journal of India 2024. link 28 Jang W, Schwartz C, Seyan Z, Garcia I, Stroever S, Awal A et al.. Effect of dexmedetomidine on postoperative adenotonsillectomy oral intake and dehydration. Auris, nasus, larynx 2024. link 29 Jacob T, Leshno M, Carmel-Neidermann NN, Kampel L, Warshavsky A, Mansour J et al.. Antibiotics or Tonsillectomy for Adult Recurrent Tonsillitis: Analyzing the Lesser of Two Evils. The Laryngoscope 2024. link 30 Espahbodi M, Edwards KM, Goudy SL, Penn EB, Manthiram K. Assessment of recurrent fever among children undergoing tonsillectomy. BMC pediatrics 2024. link 31 Cameron R, Haymes A, Pepper C, Possamai V, Blaney S, Morrison G et al.. Coblation intracapsular tonsillectomy in a paediatric tertiary centre: Revision surgery rates over a nine-year period. International journal of pediatric otorhinolaryngology 2024. link 32 Gupta T, Bowles P, Bhutta MF. Effectiveness, perceptions and environmental benefits of remote consultation for adults referred with recurrent tonsillitis. Annals of the Royal College of Surgeons of England 2024. link 33 Bola Siafa A, Choffor-Nchinda E, Andjock-Nkouo YC. Inappropriate antibiotic prescription for acute tonsillitis in low- and middle-income countries (LMICs): a systematic review and meta-analysis protocol. BMJ open 2024. link 34 Wang AJ, Cheng J. Impact of Clinical Practice Guidelines on Pediatric Tonsillectomy for Tonsillitis. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2024. link 35 Philp N, Maqsood R, Joshyulla-Prasanna A, van der Meer RB, Douglas CM, Wood M et al.. Early provision of clinical information with an 'opt in' approach improves patient experience in tonsillectomy referrals. BMJ open quality 2024. link 36 Abbas AM, Rasheed AM, Hilal SA, Mohammed-Ali SH, Al-Alwany SHM, Al-Hijazi AY et al.. Histopathological Tracing of HPV Genotypes 6 and 11 in Pediatric Patients in Medical City with Chronic Palatine and Pharyngeal Tonsillitis. Clinical laboratory 2024. link 37 Jeng PH, Yang CY, Huang TR, Kuo CF, Liu SC. Harnessing AI for precision tonsillitis diagnosis: a revolutionary approach in endoscopic analysis. 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 2024. link 38 Taha A, Yeheskeli E, Gavriel H, Berkovitch M, Mizrakli Y, Shlamkovitch N et al.. The Safety, Tolerability, and Efficacy of DL-Lactic Acid Syrup (Tonsitin) in Children With Recurrent Tonsillitis: A Pilot Study. Clinical pediatrics 2024. link 39 Hogg ES, Hampton T, Wright K, Sharma SD. The effect on the T-14 paediatric throat disorders outcome score of delaying adenotonsillectomy surgery due to COVID-19. Annals of the Royal College of Surgeons of England 2023. link 40 Gutierrez JA, Shannon CM, Nguyen SA, Labadie RF, White DR. The Impact of Surgical Indication on Posttonsillectomy Hemorrhage: A Systematic Review and Meta-Analysis. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2023. link 41 Katundu DR, Chussi D, van der Gaast-de Jongh CE, Rovers MM, de Jonge MI, Hannink G et al.. Effect of prophylactic amoxicillin on tonsillar bacterial pathogens after (adeno)tonsillectomy in children. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 2023. link 42 Smith KL, Hughes R, Myrex P. Tonsillitis and Tonsilloliths: Diagnosis and Management. American family physician 2023. link 43 Wilson JA, Fouweather T, Stocken DD, Homer T, Haighton C, Rousseau N et al.. Tonsillectomy compared with conservative management in patients over 16 years with recurrent sore throat: the NATTINA RCT and economic evaluation. Health technology assessment (Winchester, England) 2023. link 44 Zhou Y, Peng M, Zhou J. Quality of life in children undergoing tonsillectomy: a cross-sectional survey. Italian journal of pediatrics 2023. link 45 Houborg HI, Klug TE. Translation and validation of the Tonsillectomy Outcome Inventory 14 into Danish. Danish medical journal 2023. link 46 Hakanen O, Tolvi M, Torkki P. Cost analysis of face-to-face visits, virtual visits, and a digital care pathway in the treatment of tonsillitis patients. American journal of otolaryngology 2023. link 47 Büttner R, Schwermer M, Ostermann T, Längler A, Zuzak T. Complementary and alternative medicine in the (symptomatic) treatment of acute tonsillitis in children: A systematic review. Complementary therapies in medicine 2023. link 48 Plath M, Sand M, Behnen K, Plath K, Baumann I. Does a tonsillectomy indicated according to the German S2k guideline affect short-term quality of life in adults?. 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 2023. link 49 Jackson R, Rajadhyaksha EV, Loeffler RS, Flores CE, Van Doorslaer K. Characterization of 3D organotypic epithelial tissues reveals tonsil-specific differences in tonic interferon signaling. PloS one 2023. link 50 Schafer A, Worobetz N, Lukens J, Bourgeois T, Onwuka A, Elmaraghy C et al.. Assessing the Relationship Between Infection Frequency and Risk of Post-Tonsillectomy Hemorrhage. The Annals of otology, rhinology, and laryngology 2023. link 51 Vierula JP, Nurminen J, Jussila V, Nyman M, Heikkinen J, Pape B et al.. Diagnostic performance of short noncontrast biparametric 3-T MRI for tonsillar infections: comparison with a full protocol including contrast-enhanced sequences. European radiology experimental 2023. link 52 Wilson JA, O'Hara J, Fouweather T, Homer T, Stocken DD, Vale L et al.. Conservative management versus tonsillectomy in adults with recurrent acute tonsillitis in the UK (NATTINA): a multicentre, open-label, randomised controlled trial. Lancet (London, England) 2023. link00519-6) 53 Betz V, Boeger D, Buentzel J, Hoffmann K, Jecker P, Kaftan H et al.. Effect of the German tonsillitis guideline on indication for tonsil surgery in patients with recurrent acute tonsillitis: a population-based study. Scientific reports 2023. link 54 Houborg HI, Klug TE. Evaluation of Guidelines For Tonsillectomy in Adults With Recurrent Acute Tonsillitis. The Annals of otology, rhinology, and laryngology 2023. link 55 Shrestha D, Bista M. Association Between Vitamin D Deficiency and Recurrent Tonsillitis. Journal of Nepal Health Research Council 2023. link 56 Ormianer M, Koplewitz BZ, Eliashar R, Gross M, Weinberger JM, Hirshoren N. Bilateral Intratonsillar Abscesses: A Deceiving Symmetrical Oral Bulging. The Israel Medical Association journal : IMAJ 2023. link 57 Singh M, Mathur S, Jhingan P, Jain A. Assessment of changes in . Journal of the Indian Society of Pedodontics and Preventive Dentistry 2023. link 58 Yadav D, Dangol B, Shrestha N, Pandit S, Nepal A. Post-tonsillectomy Hemorrhage in Patients Receiving Ketorolac Analgesic. Kathmandu University medical journal (KUMJ) 2023. link 59 Çakıcı K, Gökdoğan O, Genç D, Günaydın B, Üçüncü H. Comparison of innate lymphoid cells from tissue and blood in chronic tonsillitis and tonsillar hypertrophy. International journal of pediatric otorhinolaryngology 2023. link 60 Allen DZ, Challapalli S, Lee KH, Bell CS, Roy S, Bowe S et al.. Impact of COVID-19 on nationwide pediatric otolaryngology practice: Adenotonsillectomies (TA) and tonsil-related diagnoses trends. American journal of otolaryngology 2022. link 61 Kuhnow A, Al-Sayed AA, Taylor B. Routine evaluation of tonsillectomy specimens: a cross-sectional survey of Canadian Otolaryngology: Head and Neck Surgeons. Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale 2022. link 62 Clark ST, Waldvogel-Thurlow S, Wagner Mackenzie B, Douglas RG, Biswas K. Fluorescence in situ hybridisation in Carnoy's fixed tonsil tissue. Scientific reports 2022. link 63 Sakki AJ, Mutka A, Nokso-Koivisto J, Mäkinen LK. Do tonsils regrow after partial tonsillectomy? - Histology of regrown tonsils and predisposing factors for tonsillar regrowth. International journal of pediatric otorhinolaryngology 2022. link 64 Hulse K, Lindsay E, Rogers A, Young D, Kunanandam T, Douglas CM. Twenty-year observational study of paediatric tonsillitis and tonsillectomy. Archives of disease in childhood 2022. link 65 Houborg HI, Klug TE. Quality of life after tonsillectomy in adult patients with recurrent acute tonsillitis: a systematic review. 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 2022. link 66 Turkki OM, Bergman CE, Lee MH, Höglund OV. Complications of canine tonsillectomy by clamping technique combined with monopolar electrosurgery - a retrospective study of 39 cases. BMC veterinary research 2022. link 67 Windfuhr JP, Günster C. Impact of the COVID-pandemic on the incidence of tonsil surgery and sore throat in Germany. 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 2022. link 68 Sagheer SH, Kolb CM, Crippen MM, Tawfik A, Vandjelovic ND, Nardone HC et al.. Predictive Pediatric Characteristics for Revision Tonsillectomy After Intracapsular Tonsillectomy. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2022. link 69 Stalfors J, Ovesen T, Bertelsen JB, Bugten V, Wennberg S, Sunnergren O. Comparison of clinical practice of tonsil surgery from quality register data from Sweden and Norway and one clinic in Denmark. BMJ open 2022. link 70 Orlovska RM, Popovych VI, Koshel IV, Bondarenko OO. FEATURES OF THE CONNECTIVE TISSUE COMPONENT OF THE PALATINE TONSILS IN PATIENTS WITH RECURRENT TONSILLITIS. Wiadomosci lekarskie (Warsaw, Poland : 1960) 2022. link 71 Kwan LY, Yip HCA, Tan S, Fan KS. A quality assessment of online patient information regarding tonsillitis using the EQIP tool. International journal of pediatric otorhinolaryngology 2022. link 72 Goldenzon RV, Lucas TO, Roiseman MML, Rodrigues MCF, Fonseca AR, Oliveira SKF et al.. Valuing tonsillitis manifestations in schoolchildren in Rio de Janeiro. Einstein (Sao Paulo, Brazil) 2022. link 73 Al-Rawashdeh BM, Altawil M, Khdair Ahmad F, Alharazneh A, Hamdan L, Muamar ASH et al.. Vitamin D Levels in Children with Recurrent Acute Tonsillitis in Jordan: A Case-Control Study. International journal of environmental research and public health 2022. link 74 Piitulainen JM, Uusitalo T, Sjöblom HM, Ivaska LE, Jegoroff H, Kauko T et al.. Intracapsular tonsillectomy in the treatment of recurrent and chronic tonsillitis in adults: a protocol of a prospective, single-blinded, randomised study with a 5-year follow-up (the FINITE trial). BMJ open 2022. link 75 Wojtera M, Barrett JW, Strychowsky JE, Dzioba A, Paradis J, Husein M et al.. The prevalence of human papillomavirus in paediatric tonsils in Southwestern Ontario. The Journal of laryngology and otology 2022. link 76 Magdalena Díaz ML, García-Cabo Herrero P, Pedregal Mallo D, Cobo Díaz R, Sopena Zubiria A, Rodrigo Tapia JP. Dependent factors in the adult patient and their relationship with post-tonsillectomy bleeding and pain in an outpatient setting. Acta otorrinolaringologica espanola 2022. link 77 Heikkinen J, Nurminen J, Velhonoja J, Irjala H, Soukka T, Happonen T et al.. MRI Findings in Acute Tonsillar Infections. AJNR. American journal of neuroradiology 2022. link 78 Aldrees T, Alzuwayed A, Majed A, Alzamil A, Almutairi M, Aloqaili Y. Evaluation of Secondary Post-Tonsillectomy Bleeding among Children in Saudi Arabia: Risk Factor Analysis. Ear, nose, & throat journal 2022. link 79 Sizer B, Deveci E, Demir S, Yorgancilar AE. Weber's gland immune/histopathology in pediatric recurrent tonsillitis and obstructive tonsillar hypertrophy cases. European review for medical and pharmacological sciences 2022. link 80 Besser G, Grasl S, Meyer EL, Schnoell J, Bartosik TJ, Brkic FF et al.. A novel electrosurgical divider: performance in a self-controlled tonsillectomy study. 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 2022. link 81 Johnston J, Wagner Mackenzie B, Biswas K, Waldvogel-Thurlow S, Clark ST, Radcliff F et al.. The Effect of Amoxicillin with Clavulanate on the Microbiota of Tonsillar Tissue in Disease: a Randomized Control Trial. Microbiology spectrum 2022. link 82 Klagisa R, Racenis K, Broks R, Balode AO, Kise L, Kroica J. Analysis of Microorganism Colonization, Biofilm Production, and Antibacterial Susceptibility in Recurrent Tonsillitis and Peritonsillar Abscess Patients. International journal of molecular sciences 2022. link 83 Mahato NB, Bista M, Bhandari B, Maharjan A. Mean Duration for Cessation of Pain following Tonsillectomy Operation among the Patients of Otolaryngology Department in a Tertiary Care Hospital: A Descriptive Cross-sectional Study. JNMA; journal of the Nepal Medical Association 2021. link 84 Jakubowski L, Leader BA, Ishman SL, Chun R, Tarima SS, Parikh S et al.. Validation of an Objective Assessment Tool for Tonsillectomy in Otolaryngology Resident Training. The Laryngoscope 2021. link 85 Na'ara S, Aronov M, Gil Z, Gordin A. Can Tonsillectomy Be Safely Performed by Residents? A Comparative Retrospective Study. The Annals of otology, rhinology, and laryngology 2021. link 86 Cereceda-Monteoliva N, Devabalan Y, Lorenz H, Magill JC, Unadkat S, Rennie C. Improving the management of suspected tonsillitis and peritonsillar abscess referred to ENT - a coronavirus disease 2019 service improvement. The Journal of laryngology and otology 2021. link 87 Çiçek MT, Aslan M. An Extraordinary Complication of Chronic Tonsillitis: Perforation of Posterior Plica. The Journal of craniofacial surgery 2021. link 88 Edwards MJ, James TW, Dalton CL. ENT UK coronavirus disease 2019 adult tonsillitis and quinsy guidelines: translating guidance into practice. The Journal of laryngology and otology 2021. link 89 Nanditha S, Gopalakrishnan S, Karthikeyan P, Singh Bakshi S. Efficacy of topical application of autologous platelet-rich plasma in adult tonsillectomy patients: a randomised control study. The Journal of laryngology and otology 2021. link 90 Balai E, Bhamra N, Gupta K, Jolly K, Barraclough J. Implementation of an acute tonsillitis management protocol within a clinical decisions unit. Annals of the Royal College of Surgeons of England 2021. link 91 Plath M, Sand M, Federspil PA, Plinkert PK, Baumann I, Zaoui K. Normative tonsillectomy outcome inventory 14 values as a decision-making tool for tonsillectomy. 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 2021. link 92 Ughasoro MD, Akpeh JO, Echendu N, Mgbachi NG, Okpala S, Amah L et al.. The profile of microorganisms that associate with acute tonsillitis in children and their antibiotics sensitivity pattern in Nigeria. Scientific reports 2021. link 93 Sievert M, Miksch M, Mantsopoulos K, Goncalves M, Rupp R, Mueller SK et al.. The value of transcutaneous ultrasound in the diagnosis of tonsillar abscess: A retrospective analysis. Auris, nasus, larynx 2021. link 94 Slouka D, Čejková Š, Hanáková J, Hrabačka P, Kormunda S, Kalfeřt D et al.. Risk of Postoperative Bleeding in Tonsillectomy for Peritonsillar Abscess, as Opposed to in Recurrent and Chronic Tonsillitis-A Retrospective Study. International journal of environmental research and public health 2021. link 95 Sanders O, Bolton L, Nemeth Z, Hardy A, Meghji S. A 4-year retrospective study of tonsillectomy rate and admission rate of tonsillitis and complications in the East of England and nationally. 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 2021. link 96 Huoh KC, Haidar YM, Dunn BS. Current Status and Future Trends: Pediatric Intracapsular Tonsillectomy in the United States. The Laryngoscope 2021. link 97 Kolb CM, Jain N, Schillinger K, Born K, Banker K, Aaronson NL et al.. Does perioperative ketorolac increase bleeding risk after intracapsular tonsillectomy?. International journal of pediatric otorhinolaryngology 2021. link 98 O'Byrne LM, Salem M, Fenton JE. What the blogosphere has to say about adult tonsillectomy. The Journal of laryngology and otology 2021. link 99 Guntinas-Lichius O, Geißler K, Asendorf T, Tostmann R, Löhler J. Tonsillectomy versus tonsillotomy for recurrent acute tonsillitis in children and adults (TOTO): study protocol for a randomized non-inferiority trial. Trials 2021. link 100 Pankhania M, Rees J, Thompson A, Richards S. Tonsillitis, tonsillectomy, and deep neck space infections in England: the case for a new guideline for surgical and non-surgical management. Annals of the Royal College of Surgeons of England 2021. link