Adenotonsillectomy in children with recurrent acute tonsillitis: review and implications for practice

This paper aims at defining the therapeutic role of (adeno)tonsillectomy in children affected by recurrent acute tonsillitis (RAT), and at drawing some practical implications based on the current evidence. A literature search was performed to find pertinent study accessible by means of a MEDLINE search (accessed via PubMed). 15 papers were selected for literature analysis. The evidence suggests that although significant, the effect of tonsillectomy in children with moderate to severe RAT is modest and limited to 12 months post-operatively. In the case of patients with mild symptoms, it seems that the benefits are not sufficient to balance the disadvantages of the procedure. This can be explained by the fact that the procedure is intrinsically characterised by pharyngeal pain and that the surgical removal of a palatine tonsil does not exclude the subsequent onset of successive episodes of pharyngitis. An analysis of the literature indicates that the efficacy of (adeno)tonsillectomy in treating pediatric RAT is generally limited and relatively transient.