For children who have a lower number of recurrent throat infections, tonsillectomy has significantly less benefits when compared to those with more frequent infections, and many children with recurrent throat infections naturally improve without intervention. Therefore, where safely possible, avoidance of tonsillectomy for children with lower numbers of acute infections is recommended. This avoids unnecessary tonsillectomy and the costs and complications associated with the procedure (i.e., bleeding, pain, infection). If tonsillectomy is not indicated, children should be closely monitored and reconsidered for tonsillectomy if the infection frequency increases, as they would be less likely to naturally improve, and more likely to benefit from tonsillectomy. Families should be counselled on the limited benefits and potential harms of performing tonsillectomy for children and adolescents with low rates of recurrent throat infections. Shared decision making is of importance when considering tonsillectomy as individual patient and family factors can impact the decision. For more information:
Burton MJ, Glasziou PP, Chong LY, Venekamp RP. Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev. 2014;(11):CD001802. PMID: 25407135.
Francis DO, Chinnadurai S, Sathe NA, Morad A, Jordan AK, Krishnaswami S et al. Tonsillectomy for obstructive sleep-disordered breathing or recurrent throat infection in children. Rockville (MD): Agency for Healthcare Research and Quality (US); 2017;Report No.:16(17)-EHC042-EF. PMID: 28182365.
Mitchell RB, Archer SM, Ishman SL, Rosenfeld RM, Coles S, Finestone SA, et al. Clinical practice guideline: tonsillectomy in children (update). Otolaryngol Head Neck Surg. 2019;160(1):S1–42. PMID: 30921525.