Indication of tonsillectomy from paediatric view points

Abstract

Tonsillectomy has been a surgical approach to treat the children with chronic tonsillitis, respiratory failure as a result of hypertrophic tonsils, and focal infection such as rheumatic fever and acute glomerulonephritis. However, pediatricians in general have recently the tendency not to refer those children to otolaryndologists for tonsillectomy. In the current study, the questionnaire-based examination was done to show the indication criteria of tonsillectomy from the viewpoint of pediatricians in six regional hospitals/institutes. In the past five years, 1 to 5 children a year were referred to otolaryngologists for a tonsillectomy because of recurrent tonsillitis (5 institutes), chronic tonsillitis (3 institutes), respiratory failure because of hypertrophic tonsils (6 institutes), and focal infection (1 institute). All pediatricians reported that the surgical approach was effective, no children progressed to an immunodeficient state, only two had a minor complication of post-operative bleeding, and that respiratory failure because of hypertrophic tonsils will be the unique indication of tonsillectomy in the future. The focal infection will be effectively treated with the administration of susceptible antibiotics instead of operative stress for children.