Adenotonsillectomy in children

Abstract

Adenotonsillar disorders are a frequent complaint in children and adenotonsillectomy is one of the commonest surgical procedures. The two main indications for adenotonsillectomy are recurrent tonsillitis and obstructive sleep apnoea (OSA). Both are associated with significant morbidity. How best to diagnose OSA is currently unclear. Some centres routinely use sleep studies whilst others rely on history alone. Intracapsular subtotal tonsillectomy, as opposed to complete tonsillectomy, is a good choice in OSA. It is as effective in relieving obstruction but typically has lower morbidity with less pain and bleeding. Postoperative complications are relatively common, and good pain management is essential. There is controversy about effectiveness of tonsil and adenoid surgery, with on-going arguments for and against. Appropriate patient selection based on clinical need and evidence, rather than rationing, is essential.

Role of Adenotonsillectomy and Tonsillectomy in Children with Down Syndrome Who Develop Obstructive Sleep Apnea by Obesity as a Risk Factor

“…Tonsillectomy and adenoidectomy are surgical procedures that remove the small glands on either side of the throat (tonsils) and at the top of the throat below the nose (adenoids). Tonsillectomy, with or without adenoidectomy, has long been studied and is one of the most commonly performed surgical procedures in the pediatric age group around the world [38,39]. The success rate of adenotonsillectomy treatment in otherwise stable, nonobese children is around 80%.…”

Bacteriology of Adenoids and Tonsils in Children With Recurrent Adenotonsillitis

“…Adenotonsillectomy is the ultimate treatment for recurrent AT. Operative intervention rates are significantly higher in children than in adolescents, and it becomes essential in children with recurrent AT and obstructive sleep apnea [5,6]. Pathogenic bacterial infections are the most common cause of AT, but microbiology may vary substantially in recurrent cases.…”