2020 Volume 123 Issue 1 Pages 48-54
We describe the longitudinal changes in the profile of tonsillectomies at a regional base hospital. During the 62-year period from 1955 to 2016, a total 27,623 surgeries were performed in the otorhinolaryngology department, with tonsillectomies accounting for 21.2% (5,852 cases). The percentage of tonsillectomies relative to the total number of otorhinolaryngologic surgeries was high in the 1960's (32%-58%), but decreased thereafter, remaining sustained at about 15%. At the beginning, tonsillectomy was performed under local anesthesia. Both local and general anesthesia were adopted between 1969 and 1987. From 1988 onward, tonsillectomies are only performed under general anesthesia. The number of tonsillectomies in males exceeded that in females during the study period (53% over the total period). The age distribution changed with time; in the 1955-60's, pediatric cases accounted for the vast majority, with the peak rate in 6- to 10-year olds; after the 1970's, a second peak appeared in young adulthood (age 21-25 years). Subsequently, in the early 2000s, the number of adult cases exceeded the number of pediatric cases. Since 2010, the proportion of pediatric cases has increased again and the adult cases are distributed over a wide age range. From the era of a large number of surgeries for patients with recurrent tonsillitis or tonsillar hypertrophy being performed under local anesthesia, general anesthesia has become the mainstay for such surgeries, and strict criteria are used to select the surgical indications. Inflammatory disease can be an indication only after its frequency and severity meet the selection criteria. A consensus has been established for pediatric cases with sleep-disordered breathing and is being established for cases with IgA nephropathy. These could explain the changes in the age distribution of the cases. Tonsillectomy still retains a significant share of the surgeries performed in the field of otorhinolaryngology.
