Indications for tonsillectomy: a 10 year retrospective review.

OBJECTIVE

Recurrent tonsillitis and obstructive sleep apnea (OSA) are the most common indications for tonsillectomy. This study was undertaken to determine if recurrent tonsillitis is increasing as an indication for tonsillectomy by reviewing the recent trend at a single institution.

METHODS

A retrospective chart review of patients undergoing tonsillectomy from 2003 to 2012 was performed. Data was gathered from pre-operative symptoms and sleep study results. Patients were categorized by the following indications: (1) obstructive sleep apnea, (2) recurrent tonsillitis and OSA, (3) recurrent tonsillitis alone and (4) other. Literature review was conducted to find similar studies; the results of the literature review were compared to our results.

RESULTS

A total of 2369 patients were included, 52% were boys. Over the study period OSA was the indication for surgery for 67% of patients. There was an increasing trend in OSA as the indication for tonsillectomy (p<0.0001). Girls were more likely to have tonsillitis as an indication for tonsillectomy (21% vs. 17%, OR: 1.32, p<0.0001). Children younger than 2 or 2-5 are less likely than those older than 5 to have tonsillitis as an indication for surgery (2.30% and 6.26% vs. 27.46%, OR=0.06 and 0.18, p<0.0001). 987 of 2370 (42%) patients undergoing tonsillectomy had a pre-operative sleep study. Younger children were more likely to have had a sleep study.

CONCLUSION

There were mild variations from year to year; however, obstructive sleep apnea is the most common reason for tonsillectomy.