Tonsillectomy and adenoidectomy.

Introduction Although the number of tonsillectomy and adenoidectomy procedures has declined over the past 50 to 60 years, these operations continue to be among the procedures performed most commonly in the United States, second only to myringotomy with tube insertion. According to the most recent compilation of national health statistics (1996), more than 287,000 children younger than age 15 years underwent tonsillectomies with and without adenoidectomy; approximately 129,000 children underwent adenoidectomy without tonsillectomy. Despite being common procedures, the indications for tonsillectomy and adenoidectomy remain controversial. There have been few randomized, controlled clinical trials to help the primary care practitioner recommend which children to refer for tonsillectomy or adenoidectomy. Clinicians often feel pressured by parents and families to recommend such procedures. Tonsillectomies are performed most commonly on children who have obstructive sleep apnea syndrome (OSAS) and recurrent throat infections. The primary indication for adenoidectomy is adenoid hypertrophy, with resultant upper airway obstruction.