Indications for tonsillectomy and adenoidectomy.

Tonsillectomy and adenoidectomy are separate procedures that should be performed for distinct reasons. Studies now indicate that severe, recurrent pharyngitis responds well to tonsillectomy. According to separate recommendations from the American Medical Association and the American Academy of Pediatrics, patients are candidates for tonsillectomy if they have four or more episodes of pharyngitis a year. Recurrent otitis media and chronic otitis media are improved by adenoidectomy, although placement of pressure-equalizing tubes remains the preferred initial treatment for these conditions. Adenotonsillectomy improves severe upper airway obstruction (cor pulmonale and obstructive sleep apnea), as well as milder forms of airway obstruction (loud snoring). The effectiveness of these procedures in proposed indications, such as sinusitis and adenoiditis, is less well substantiated.