Indications for tonsillectomy and adenoidectomy.
OBJECTIVE
To review recent clinical trials that provide a foundation on which clinicians can base decisions regarding adenotonsillar surgery for their patients.


METHODS
Review.


METHODS
An evidence-based approach was used to review recent clinical trials addressing indications for adenotonsillectomy, tonsillectomy, and adenoidectomy.


RESULTS
Absolute indications for tonsillectomy and adenoidectomy include adenotonsillar hyperplasia with obstructive sleep apnea, failure to thrive, or abnormal dentofacial growth; suspicion of malignant disease; and (for tonsillectomy) hemorrhagic tonsillitis. Relative indications for both procedures are adenotonsillar hyperplasia with upper airway obstruction, dysphagia, or speech impairment, and halitosis. Otitis media and recurrent or chronic rhinosinusitis or adenoiditis are relative indications for adenoidectomy but not tonsillectomy. Recurrent or chronic pharyngotonsillitis, peritonsillar abscess, and streptococcal carriage are relative indications for tonsillectomy but not adenoidectomy.


CONCLUSIONS
Good clinical evidence regarding indications for tonsillectomy and adenoidectomy is available. Clinicians should make recommendations for surgery on the basis of this evidence.
Darrow
David H
DH
Departments of Otolaryngology and Pediatrics, Eastern Virginia Medical School, and the Department of Otolaryngology, Children's Hospital of The King's Daughters, Norfolk, Virginia 23507, USA. darrowdh@chkd.com
Siemens
Christopher
C
D000233:Adenoidectomy / Q000592:standards* / Q000639:trends; D000402:Airway Obstruction / Q000175:diagnosis / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008297:Male; D000039:Peritonsillar Abscess / Q000175:diagnosis* / Q000601:surgery*; D011379:Prognosis; D012720:Severity of Illness Index; D014068:Tonsillectomy / Q000592:standards* / Q000639:trends; D014069:Tonsillitis / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome