Tonsillectomy Guidelines for Children

Approximately 530,000 tonsillectomies are performed each year in the United States, making these surgeries the second most routinely performed operation on children. The two most com­mon indications for tonsillectomy are recurrent throat infections and sleep-disordered breathing (SDB). The overall incidence rate of tonsillectomy appears to have significantly increased in the past 35 years, with SDB as the primary indication for surgery. Children with SDB have a significantly higher rate of antibiotic use, 40% more hospital visits, and a 215% higher rate of healthcare usage. A growing body of evidence indicates that tonsillectomy is an effective treatment for resolving SDB and improving quality of life (QOL). In an issue of Otolaryngology–Head and Neck Surgery, the American Academy of Otolaryngology–Head and Neck Surgery published a multidis­ciplinary clinical practice guideline on tonsillectomy in children. “It’s important that clinicians have evidence-based guidelines for these procedures so that they will be empowered to help patients make the best treatment decisions,” says Reginald F. Baugh, MD, who chaired the guideline committee. “The goals of the guidelines are to make surgery safer and to improve QOL for children who undergo tonsillectomy.” The guideline is intended for all clinicians who care for children between the ages of 1 and 18 being considered for tonsillectomy. It helps identify children who are the best candidates for tonsillectomy. It also provides information on peri­operative care, management options for special patient populations, and counseling strategies. Guideline Recommendations for Tonsillectomy The clinical practice guidelines for tonsillectomy in children outlined 10 specific recommendation state­ments to assist clinicians who manage these patients (Table 1). The statements describe specific aspects to consider with regard to surgical indications...