[Adenotonsillectomy in children: not yet scientifically validated].
Tonsillectomy, in 90% of cases combined with adenoidectomy, is one of the most frequently carried out operations on children in the Netherlands: in 1998 there were 33,471 operations in children aged 0-14 years. This high frequency is in stark contrast to the scientific basis for the efficacy of this intervention. A meta-analysis carried out recently revealed just one good study. The lack of scientifically based clinical guidelines, partly explains the large international and regional differences in the number of operations carried out. In the Netherlands only 35% of the children operated on satisfy one of the criteria for which the effectiveness of (adeno)tonsillectomy has been established: frequent recurrent tonsillitis or obstructive sleep apnoea. A project has been started in the Netherlands to further study the effectiveness of this intervention, the results of which must contribute to a more thoroughly substantiated indication.
van Staaij
B K
BK
Universitair Medisch Centrum Utrecht, Julius Centrum voor Huisartsgeneeskunde en Patiëntgebonden Onderzoek, Postbus 85.060, 3508 AB Utrecht. b.k.vanstaaij@wkz.azu.nl
van den Akker
E H
EH
Poels
P J P
PJ
Hoes
A W
AW
Schilder
A G M
AG
D000233:Adenoidectomy / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D000234:Adenoids / Q000473:pathology / Q000601:surgery*; D002648:Child; D006801:Humans; D006984:Hypertrophy; D015201:Meta-Analysis as Topic; D009426:Netherlands / Q000453:epidemiology; D013517:Otorhinolaryngologic Surgical Procedures / Q000592:standards; D014066:Palatine Tonsil / Q000473:pathology / Q000601:surgery*; D010612:Pharyngitis / Q000601:surgery; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D014068:Tonsillectomy / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data