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New Tonsillectomy Guidelines for Doctors, Families


How many sore throats should a child have before he or she is considered for a tonsillectomy? What is the best way for parents to manage their child’s pain after a tonsillectomy? These and many other questions are covered under new tonsillectomy guidelines for doctors, patients, and their families.

Most tonsillectomies are done in children under 15

The journal Otolaryngology—Head and Neck Surgery has published multidisciplinary, evidence-based guidelines entitled “Tonsillectomy in Children” that includes recommendations on pre- intra- and postoperative care and management of children aged 1 to 18 years who are being considered for tonsillectomy. In the United States, more than 530,000 tonsillectomies are performed each year in children younger than 15 years old.

According to Richard M. Rosenfeld, MD, MPH, journal guidelines author and consultant, the new guidelines are not just for doctors. “The tonsillectomy guideline will empower doctors and parents to make the best decisions, resulting in safer surgery and improved quality of life for children who suffer from large or infected tonsils.”

While the new guidelines provide clinicians with assistance in identifying which children are the best candidates for tonsillectomy, it also offers guidance on management options for patients and families, improving counseling and education for families considering tonsillectomy for their child, and highlights the need for evaluation in special populations, such as obese children and those with Down syndrome.

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“Tonsillectomy in Children” is the first evidence-based national guideline to assist doctors in providing the highest quality care for children and help them recover safety and quickly.

According to the American Academy of Otolaryngology—Head and Neck Surgery, the number of tonsillectomies performed in the United States has been declining progressively since the 1970s. The reasons they are done has changed, too. In the 1970s, about 90 percent of the procedures were done for recurrent infection, but today about 20 percent are related to infection and 80 percent are because of obstructive sleep problems.

When a tonsillectomy is performed in properly chosen children, it can improve a child’s quality of life and sleep habits, and reduce throat infections, the need for doctor visits, and antibiotic use. Data show, for example, that bed-wetting, poor school performance, and behavior problems in children with obstructive sleep problems improve following tonsillectomy to correct this medical condition.

What are the best treatment options for children who have undergone a tonsillectomy? The answer can be found in the complete clinical guidelines for tonsillectomy, which is available online in the January issue of Otolaryngology—Head and Neck Surgery.

American Academy of Otolaryngology—Head and Neck Surgery
Baugh RF et al. Otolaryngology—Head and Neck Surgery 2010 Dec; 144(1): Suppl S1-30