Evolving Indications for Tonsillectomy

Abstract

Objectives: Determine if there is a change in the trend of indication for tonsillectomy in a pediatric population over the last 9 years. Recurrent tonsillitis and obstructive sleep apnea are the two most common indications for tonsillectomy. Recurrent tonsillitis was the most common indication for tonsillectomy from the 1950s to 1980s. With the advent and effectiveness of antibiotic therapy for treatment of tonsillitis, however, recurrent tonsillitis has become a less prevalent indication. Methods: A retrospective chart review of patients undergoing tonsillectomy from 2003 to 2012 at a tertiary care children’s hospital was performed. Patients were categorized by indication with the following group classifications: 1) Obstructive sleep apnea/sleep disordered breathing (OSA/SDB), 2) Recurrent tonsillitis and SDB/OSA, and 3) Recurrent tonsillitis alone. The data were analyzed using SPSS software. Results: A total of 2367 patients undergoing tonsillectomy were identified, 52% male, with mean age of 6.4 years. The frequency of OSA as an indication for tonsillectomy increased from 37% in 2003 to an average of 71% over the last 3 years. In 2003, 33% of children underwent tonsillectomy for recurrent tonsillitis alone. This dropped to a low of 10.5% in subsequent years. In the last half of 2011 and throughout 2012, the incidence increased to about 19%. Children with OSA and sore throats together as an indication for surgery has run about 12% over the last 5 years. Conclusions: Recurrent tonsillitis dropped in frequency around 2005, but more recently there has been a trend toward an increase in its frequency.