Indications for tonsillectomy in children: traditional and modern approached to surgery

Abstract

This literature review describes the evolution of ideas about indications for tonsillectomy in children from the early 20th century to the present. Tonsillectomy has been used as a treatment option for more than 3,000 years and remains one of the most common surgical procedures today, but there is still no consensus on the indications for total tonsillectomy and criteria for outcome evaluation. In many countries, including the Russian Federation, the priority of protecting children’s health is one of the basic principles of healthcare, so the question of when to perform tonsillectomy in children is particularly relevant. Researchers believe that no other procedure was performed in children as frequently as tonsillectomy in the first half of the 20th century. During the polio epidemic of the 1950s and 1960s, the number of tonsillectomies performed declined due to a suspected link between the surgery and bulbar poliomyelitis. Later, the discovery of antibiotics and active immune system research changed the approach to tonsillectomy. The available foreign literature describes two main indications for tonsillectomy in children: obstructive sleep apnea and recurrent infection, with obstruction becoming a more important indication in younger children. However, many authors report that the number of tonsillar complications is currently rising, probably due to a shift away from predominantly surgical treatment of tonsillar disorders. Although the history of tonsillectomy goes back several thousand years, there are no consensus guidelines for the treatment of tonsillar disorders in children, so further research are required.

Keywords

tonsillectomy / chronic tonsillitis / obstructive sleep apnea / palatal tonsils / hypertrophy of palatal tonsils

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