Indications for Tonsilectomy in Adults and Children

Dear Ask The Doctor: What are the current recommendations for tonsillectomy procedure in children and in adults? Is there a difference in outcome if the surgery is delayed until the child is older? Do you have to have confirmed cases of Strep throath to be considered a surgical candidate? How long is the recovery period? What are alternatives to surgery? Thank you for you help and assistance

Dear Suneel: The indications for tonsillectomy are the same in adults and children. Some of the indications listed below are not absolute and are at the discretion of the patient and surgeon.

1. Significantly enlarged tonsils that cause sleep apnea, breathing difficulty or difficulty swallowing.
2. Tonsillitis causing seizures in children
3. Development of a tonsillar absecess that doesn’t respond to antibiotics
4. Three or more episodes of tonsillitis per year
5. Persistent bad breath from chronic tonsillitis
6. Suspected cancer

Confirmed strept throat is not an indication for tonsillectomy. However, strept throat which is not responding to antibiotics may require tonsillectomy.

There are no alternatives for surgery. If surgery is absolutely indicated then it is the only option.

There is no difference in outcome regardless of age. However, surgery should not be delayed unnecessarily especially in cases of sleep apnea or suspected cancer.

The recovery period is usually short and most persons are back to a normal diet within a few days.