Pediatria pre prax 5/2013

The indications for tonsillectomy and tonsillotomy in children

Tonsillectomy, surgical removal of palatine tonsils, is one of the oldest surgical procedure in otorhinolaryngology as well as one of the most common operations under general anesthesia in children. Two most common indications for tonsillectomy in children are obstruction of breathing caused by (adeno)tonsillar hypertrophy and recurrent or chronic tonsillitis (12). The complications of the surgery are mainly postoperative bleeding, present in approximately 20%, pain, problematic oral intake and in children under 6 years also loss of immunocompetent lymphatic tissue (15). According to multiple studies, tonsillotomy, partial removal of tonsillar tissue, is associated with less postoperative bleeding and pain as well as shorter recovery period (2). Opinions about Indications for tonsillectomy and tonsillotomy differ among Slovak and foreign experts. Multiple indications for tonsillectomy exist, but tonsillotomy should be reserved for small children with tonsillar hypertrophy causing snoring and disordered sleep without history of chronic bacterial tonsillitis (8).

Keywords: tonsillectomy, tonsillotomy, OSAS, recurent tonsillitis, chronic tonsillitis, children.