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The
following Indications for adenotonsillectomy and management vary widely and the above are only
guidelines.
1.
Patients with 3 or more infections of tonsils and/or adenoids per year
despite adequate medical
therapy.
2.
Hypertrophy
(enlargement) causing dental malocclusion or
adversely affecting oral-facial (mouth-face) growth documented by
orthodontist.
3.
Hypertrophy
causing upper airway obstruction (sleep apnea) View
Abstract
View
Abstract, severe
dysphagia
(trouble swallowing), sleep disorders, or cardiopulmonary
complications.
4.
Peritonsillar abscess
unresponsive to medical management and
drainage documented by surgeon, unless surgery performed during acute
stage.
View Tonsillectomy Surgery Video
View Drainage Surgery Video
5. Persistent foul taste or breath due to chronic tonsillitis not
responsive to medical therapy.
6. Chronic or recurrent tonsillitis associated with the
streptococcal carrier state and not responding to beta-lactamase-resistant
antibiotics.
7. Unilateral tonsil
hypertrophy
presumed euplastic. Although without other indications (abnormal
appearance, physical examination, symptoms or history) most asymmetries can
be followed conservatively.
View Abstract
8. Recurrent
acute otitis media
or
chronic serous otitis media.
Adenoidectomy should not be performed with the insertion of the first set of
myringotomy (ear) tubes
unless there is another
indication for adenoidectomy besides chronic
otitis media.
However, repeat surgery for chronic
otitis media
should consist of
adenoidectomy with
myringotomy
(with or without
myringotomy (ear) tube placement.)
View Abstract
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Describing Tonsillar Size
Brodsky Grading System
Grade
0: Tonsils within the tonsillar fossa.
Grade
1: Tonsils just outside of the tonsillar fossa, <=25% of the
oropharyngeal width.
Grade
2: Tonsils occluding 26 to <=50% of the oropharyngeal width.
Grade
3: Tonsils occluding 51 to <75% of the oropharyngeal width.
Grade 4: Tonisl occluding greater than 75% of
the oropharyngeal width.
View Abstract |
