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Tonsillectomy and adenoidectomy in children: Indications and contraindications


Tonsillectomy and adenoidectomy are common surgeries in children. The two major indications for these procedures are, respectively, obstruction and infection involving the upper respiratory tract and the deglutitory pathway.

An overview of the epidemiology and the indications and contraindications for tonsillectomy and/or adenoidectomy are presented below. Preoperative, intraoperative, and postoperative care and complications are discussed in detail separately. More detailed information regarding the conditions for which these procedures may be indicated is provided separately. (See "Tonsillectomy and/or adenoidectomy in children: Preoperative and intraoperative care" and "Tonsillectomy (with or without adenoidectomy) in children: Postoperative care and complications" and "Adenoidectomy in children: Postoperative care and complications".)


Tonsillectomy is among the most commonly performed operations in children. The frequency with which tonsillectomy is performed varies from country to country and region to region [1-3]. The variation appears to be related to differences in the medical practice of general practitioners, pediatricians, and otolaryngologists in the management of recurrent tonsillitis and other conditions affecting the upper airway [4]. Patient/family factors and preferences may also influence the decision [5].

In the United States, the number of tonsillectomies has declined progressively since the 1970s [6,7]. Reports suggest that the decline has mainly involved tonsillectomies performed for infectious indications, while the number of tonsillectomies performed for obstructive indications may have actually increased [8,9]. In 2006, an estimated 530,000 tonsillectomies (with or without adenoidectomy) and 132,000 adenoidectomies (without tonsillectomy) were performed in children younger than 15 years of age [7]. Most of these operations are performed as ambulatory, same-day procedures [7].

The rates for specific procedures vary depending upon age and sex. Tonsillectomy alone is performed infrequently in children younger than three years of age, whereas adenoidectomy alone is performed infrequently in individuals older than 14 years of age. The rate of adenoidectomy is about 1.5 times as high in boys as in girls, whereas the rate of tonsillectomy is about one-third higher in girls than in boys [5,7].


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Literature review current through: Jul 2014. | This topic last updated: Jul 22, 2014.
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