Tonsillectomy and adenoidectomy: changing trends.

A review of 1,722 tonsil and adenoid procedures performed between 1978 and 1986 is presented. Each year there has been a progressive decrease in the number of procedures performed; the incidence of adenoidectomy has declined particularly. Although infection remains the predominant indication for surgery, there has been a dramatic rise in obstructive sleep apnea as a significant indication, from 0% in 1978 to 19% in 1986. At present, this trend promises to continue as physicians become increasingly aware of the prevalence and seriousness of adenotonsillar hypertrophy as a cause of sleep apnea, particularly in the general pediatric population.