Current Belgian adenotonsillectomy practice: a survey among Belgian ENT specialists

Tonsillectomies and adenotonsillectomies (TE and ATE) are among the most frequently performed operations in the western world. Despite the lack of generally accepted clinical guidelines about indications, the beneficial role of the procedure has been established. The aim of this study was to identify current practice relating to indications for tonsillectomies and adenotonsillectomies among Belgian ENT specialists.

An anonymous questionnaire was sent to all Belgian ENT specialists. Part I of the questionnaire included questions about the ENT specialist himself/herself and his/her practice. Part II comprised questions about indications for TE/ATE in children up to 16 years of age. Part III included questions about indications in adults.

238 out of 528 questionnaires were completed and returned. The majority of physicians consider TE/ATE to be indicated if a child or an adult suffers 3 or 4 tonsillitis episodes per year. The decision to operate on children for upper airway obstruction is mainly based on clinical and anamnestic findings. A peritonsillar abscess is usually considered to be an indication for surgery. We compared the results between different groups of ENT specialists and could detect differences in decision-making only according to the number of years of ENT practice. The stringency of surgeons' indications decreases with increasing surgeon age.

The majority of respondents consider tonsillectomies/adenotonsillectomies to be indicated after 3 to 4 episodes of tonsillitis per year. In the case of upper airway obstruction in children, surgical indications are mainly based on clinical and anamnestic findings. Surgical decision-making appears to be influenced by the number of years of ENT practice.