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Indications for paediatric tonsillectomy GP versus Consultant perspective

Published online by Cambridge University Press:  29 June 2007

M. J. Donnelly
Affiliation:
Department of Otolaryngology, National Children's Hospital, Harcourt Street, Dublin 2, Ireland.
M. S. Quraishi
Affiliation:
Department of Otolaryngology, National Children's Hospital, Harcourt Street, Dublin 2, Ireland.
D. P. McShane*
Affiliation:
Department of Otolaryngology, National Children's Hospital, Harcourt Street, Dublin 2, Ireland.
*
Mr Donald P. McShane, Department of Otolaryngology, National Children's Hospital, Harcourt Street, Dublin 2, Ireland.

Abstract

Tonsillectomy is a commonly performed operation in children. Although the justification for this procedure has been debatable in the past, more rigorous criteria in defining the need for tonsillectomies are becoming established. The role of the primary care physician in the management of tonsillar disease in children is important as the decision to refer a child for tonsillectomy is made by the general practitioner. A questionnaire survey of 400 general practitioners (GPs) and 31 consultant ENT surgeons was carried out to establish the important criteria used in deciding the need for paediatric tonsillectomy. We found that in general there was a good correlation between GP and Consultant indications for tonsillectomy. However there were two important areas of difference, while most of the GPs felt that recurrent ear infections and ‘glue ear’ were important indications for tonsillectomy, Consultants did not. Therefore we must be aware of the current recommendations for tonsillectomy and inform present and future GPs.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1994

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References

Barr, G. (1989) Further thoughts about tonsillectomy. Irish Medical Journal 82: 142143.Google ScholarPubMed
Barr, G. S., Crombie, I. K. (1989) Comparison of size of tonsils in children with recurrent tonsillitis and in controls. British Medical Journal 298: 804.CrossRefGoogle ScholarPubMed
Bloor, M. J., Venters, G. A., Samphier, M. L. (1978) Geographical variations in the incidence of operations on the tonsils and adenoids – an epidemiological and sociological investigation: II. Journal of Laryngology and Otology 92: 883895.CrossRefGoogle Scholar
Bluestone, C. D. (1985) Effect of adenoids, tonsils and adenoidectomy (with or without tonsillectomy) on eustachian tube function. Annals of Otology, Rhinology and Laryngology 120 (Suppl.): 42.CrossRefGoogle Scholar
Bulletin of the American Academy of Otolaryngology – Head and Neck Surgery (1986) 5: 20.Google Scholar
Cable, H. R., Batch, A. G., Stevens, D. J. (1986) The relevance of physical signs in recurrent tonsillitis in children. Journal of Laryngology and Otology 100: 10471051.CrossRefGoogle ScholarPubMed
Carne, S. (1988) Tonsillectomy: GP assessment is the vital factor. Modern Medicine of Ireland 18: 11.Google Scholar
Freeland, A. P., Curley, J. W. A. (1987) The consequences of delay in tonsil surgery. Otolaryngological Clinics of North America 20: 405408.CrossRefGoogle ScholarPubMed
Jakins, P. S. (1893) Remarkable increase in bodily growth following removal of tonsils and adenoids. Journal of Laryngology and Otology 7: 427.CrossRefGoogle Scholar
Kearns, D. B., Pransky, S. M., Seid, A. B. (1990) Current concepts in pediatric adenotonsillar disease. Ear, Nose and Throat Journal 70: 1519.Google Scholar
Kornblut, A. D. (1987) A traditional approach to surgery of the tonsils and adenoids. Otolaryngological Clinics of North America 20: 349363.CrossRefGoogle ScholarPubMed
Mauer, K., Staats, B., Olsen, K. (1983) Upper airway obstruction and disordered nocturnal breathing in children. Mayo Clinic Proceedings 58: 349353.Google ScholarPubMed
Maw, A. R. (1983) Chronic otitis media with effusion (glue ear) and adenotonsillectomy: prospective randomized controlled study. British Medical Journal 287: 15861588.CrossRefGoogle Scholar
Maw, A. R. (1986) Tonsillectomy today. Archives of Disease in Childhood 61: 421–123.CrossRefGoogle ScholarPubMed
MacBeth, R. G. (1950) The tonsil problem. Journal of Laryngology and Otology 64: 591598.Google Scholar
Paradise, J. L., Bluestone, C. D., Bachman, R. Z., Karantonis, G., Smith, I. H., Saez, C. A., Colburn, D. K., Bernard, B. S., Taylor, F. H., Schwarzbach, R. H., Felder, H., Stool, S. E., Fitz, A. M., Rogers, K. D. (1978) History of recurrent sore throat as an indication for tonsillectomy: predictive limitations of histories that are undocumented. New England Journal of Medicine 298: 409413.CrossRefGoogle ScholarPubMed
Paradise, J. L., Bluestone, C. D., Bachman, R. Z., Colburn, D. K., Bernard, B. S., Taylor, F. H., Rogers, K. D., Schwarzbach, R. H., Stool, S. E., Friday, G. A., Smith, I. H., Saez, C. A. (1984) Efficacy of tonsillectomy for recurrent throat infection in severely affected children. New England Journal of Medicine 310: 674683.CrossRefGoogle ScholarPubMed
Potsic, W. (1987) Comparison of polysomnography and sonography for assessing regularity of respiration during sleep in adenotonsillar hypertrophy. Laryngoscope 97: 14301437.CrossRefGoogle ScholarPubMed
Rutkow, I. M. (1986) Ear, nose and throat operations in the United States, 1979–1984. Archives of Otolaryngology, Head and Neck Surgery 112: 873.CrossRefGoogle Scholar
Tate, N. (1963) Deaths from tonsillectomy. Lancet 2: 10901091.CrossRefGoogle ScholarPubMed
Williams, A. J. (1967) Haemorrhage following tonsillectomy and adenoidectomy. Journal of Laryngology and Otology 81: 805808.CrossRefGoogle ScholarPubMed