Gigante J: Tonsillectomy and adenoidectomy. Pediatr Rev 2005;26(6):199-202.
Tonsillectomy and adenoidectomy are no longer thought of as routine childhood procedures, but they remain second only to myringotomy as a common surgery for children. This article reviews anatomy, clinical presentation, indications, and complications for both procedures. Tonsillectomy and/or adenoidectomy can be recommended for malignancy, obstruction, or infection. Throat infections and obstructive sleep apnea syndrome are the most common indications, and depending on the study, these procedures are recommended after 3 to 7 episodes of infections over a varying period of time (1 to 3 years). While complications are rare, they include anesthetic complications and bleeding, which can occur within 24 hours to as late as 2 weeks postoperatively.
Velopharyngeal insufficiency can occur and, if it is not transient, may require speech therapy and surgical repair. The benefits of tonsillectomy are marginal and randomized. Controlled clinical trials are needed to provide better decision-making for the need for such procedures.