Related Experiment Videos
Current indications for tonsillectomy and adenoidectomy
1University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, Pennsylvania 15213.
Insights
Tonsillectomy and adenoidectomy are common pediatric surgeries for throat and breathing issues. Treatment decisions for these conditions, including acute otitis media, should be individualized based on illness severity and patient history.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Clinical Practice Guidelines
Background:
- Tonsillectomy and adenoidectomy are the most frequent pediatric surgical procedures in the US.
- These surgeries address conditions like recurrent acute tonsillitis, chronic tonsillitis, tonsillar hypertrophy, and peritonsillar abscess.
Purpose of the Study:
- To review the efficacy and indications for tonsillectomy and adenoidectomy in pediatric patients.
- To discuss treatment options for obstructive adenoids and acute otitis media.
Main Methods:
- Review of current clinical practices and available evidence for tonsillectomy and adenoidectomy.
- Discussion of treatment considerations for related pediatric conditions.
Main Results:
- Tonsillectomy is effective for various tonsil-related infections and hypertrophy.
- Adenoidectomy's role in sinusitis lacks clinical trials; allergy and antimicrobials are considered.
- Acute otitis media management varies, with surgery (including adenoidectomy) being an option.
Conclusions:
- Individualized patient assessment is crucial for deciding on otic and pharyngeal surgery.
- Treatment choices should weigh illness severity, duration, frequency, prior treatments, and risks.
Abstract:
Tonsillectomy and adenoidectomy are currently the most common pediatric surgical procedures performed in the United States. Tonsillectomy may be effective in recurrent acute throat infection (acute tonsillitis), chronic tonsillitis, tonsillar hypertrophy, and peritonsillar abscess. Antimicrobial therapy may also be beneficial. Clinical trials evaluating children with obstructive adenoids are currently being evaluated; anecdotal evidence points to improvement in development and quality of life after surgery. The efficacy of adenoidectomy in paranasal sinusitis has not been evaluated in clinical trials; antimicrobial therapy or the possibility of upper respiratory tract allergy should be considered in such cases. For acute otitis media, recommendations range from no treatment in cases that will abate with time, to anti-microbial prophylaxis, to myringotomy with tympanostomy tube insertion, adenoidectomy with or without tonsillectomy, or a combination of adenoidectomy with myringotomy and/or tympanostomy tubes. The decision for or against otic and/or pharyngeal surgery should be individualized on the basis of severity, duration, and frequency of illness; previous treatment; and risk.