Tonsillectomy in Children

Improvements in behavioral and neurocognitive symptoms have been seen in observational studies for up to 2 years after tonsillectomy. While the evidence for tonsillectomy in children with SDB is based on observational studies, it appears that there is benefit.

Bottom Line

This guideline provides an evidence-based approach to the commonly encountered decision of when to send children on for consideration of tonsillectomy.

In children who do not meet the Paradise criteria outlined above – either because their recurrences of infection are less than seven times in the last year or five times a year for the past 2 years, or because the cause of the infections where not well documented – a watchful waiting approach without surgery is recommended.

For children who have a frequency and severity of infection that meet the Paradise criteria, tonsillectomy may be considered. Tonsillectomy may also be considered for children who have significant symptoms from sleep disordered breathing and significantly enlarged tonsils.

References

• Clinical practice guideline: Tonsillectomy in Children. (Otolaryngol. Head and Neck Surg. 2011;144:S1-30).

Dr. Thuener is a second-year resident at Abington (Pa.) Memorial Hospital. Dr. Skolnik is an associate director of the family medicine residency program at Abington Memorial Hospital.