Current views on the indications and techniques for tonsillectomies in children

Address for correspondence: Martine FRANÇOIS, ENT Service, Hospital Robert Debré, 48 boulevard Sérurier, 75019 Paris. martine.francois@rdb.aphp.fr

Abstract

There are two principal indications for tonsillectomies or ablation of palatal tonsillar tissue: repeated episodes of tonsillitis (at least 5 times per year in two successive years) and obstructive tonsillar tissue as well as another, more rare, indication, highly asymmetrical blocs of tonsillar tissue that may suggest presence of a lymphoma. When tonsils are obstructive in patients suffering from sleep apnea, the indication for excision is formal and requires prompt attention. In other cases of enlarged tonsils the indication for surgery can be discussed but practitioners must inform parents of the possible maxillofacial complications that may develop because of chronic pharyngeal blockage.

Surgeons perform tonsillectomies on children under general anesthesia, protecting the lower airways by intubation. Post-operative pain after surgery is constant and practitioners must be prepared to manage it in conformity with the age of patients and the difficulties they have in swallowing.