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Abstract
Adenotonsillectomy in Children with Recurrent Acute Tonsillitis: Review and Implications for Practice Adenotonsillectomy in Recurrent Acute Tonsillitis
Highlights
Acute pediatric pharyngotonsillary inflammation is very frequently encountered in clinical practice, and its symptoms often limit children’s everyday activities
This paper aims at defining the therapeutic role oftonsillectomy in children affected by recurrent acute tonsillitis (RAT), and at drawing some practical implications based on the current evidence
A) Children with moderate or severe episodes [5] who undergo surgery generally experience a significant but predictable period of pharyngeal pain immediately after surgery and a further two episodes in the subsequent 12 months (1 predictable + 2 unpredictable episodes = 3 episodes in total) against an average of 3.6 unpredictable episodes in conservatively treated patients; depending on the case series, this average difference of 0.6 episodes may vary from 0.1 to 1.0 episodes, and so there may be no real difference between the two groups
Summary
Acute pediatric pharyngotonsillary inflammation is very frequently encountered in clinical practice, and its symptoms often limit children’s everyday activities. A number of children have recurrent or persistent symptoms characterised by a succession of acute infections associated with fever, pharyngeal pain, general malaise and, respiratory sleep disorders, and the limitations on their everyday activities cause them to miss school and prevent their parents from going to work In such cases, (adeno)tonsillectomy can be considered, it is necessary to consider the possible risks of surgery, including those related to the use of general anesthesia [1,2,3]. Probably not the only cause, the palatine tonsils certainly play a major role in the genesis of episodes of recurrent acute pharyngeal inflammation, which means that, even if it cannot eliminate the risk, tonsillectomy could theoretically prevent further episodes of pharyngeal pain and/or reduce the severity of subsequent infections, improving the patient’s quality of life [4]. This paper will provide an overview on pathogenesis and surgical treatment of recurrent acute tonsillitis (RAT) in children (Section 1) and it will review the therapeutic role of (adeno)tonsillectomy such patients to draw practical recommendations for clinical practice (Section 2)
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