More than half a million children under 15 in the United States go under the knife each year to have their tonsils removed. As such, it’s one of the most common surgical procedures. It’s not a totally benign procedure — the bleed rate is 5 percent or a few tens of thousands — and obviously, the more often it’s done, the more chance for complications.

Key recommendations include a watch-and-wait policy, only considering doctor-documented infections, and advising against the routine giving of antibiotics for recovery.

The vast majority of tonsillectomies in children are now performed for sleep apnea and not for recurrent infections. Pediatric sleep apnea is common and can affect both daytime behavior and cognition. In adults the procedure may be undertaken for chronic bad breath, tonsillitis, recurrent sore throats and suspicion of cancer. At one time, it was accepted practice to perform tonsillectomies on whole families at a time.

The new guidelines recommend a more conservative approach of “watchful waiting” to see if the problem doesn’t resolve by itself.

New guidelines

They include the following points:

• Watchful waiting is best for most children with fewer than seven throat infections a year;

• Doctors should ask parents of children with large tonsils and sleep-disordered breathing about problems that might improve after tonsillectomy, including growth delay, school performance, bedwetting and behavioral problems.

• Doctors should not routinely prescribe antibiotics following tonsillectomy.

Ref: http://www.dailypress.com/health/dp-nws-tonsillectomy-20110215,0,5536084.story