New Guidelines for Tonsillectomies in Children

Find out what to do when your child has a persistent sore throat.

New Guidelines for Tonsillectomies in Children

At the 1998 Grammys, Luciano Pavarotti backed out of performing at the last minute because of a sore throat—and Aretha Franklin stepped in to give a moving gospel-operatic rendition of the aria Nessun Dorma!

Rarely does a sore throat lead to such astounding moments of artistry. In fact, according to a new study from Birmingham University, for seven out of eight kids in the UK who have their tonsils removed, the surgery isn’t even necessary!

In the US, more than a half a million tonsillectomies are preformed annually. Three decades ago, 90 percent were because of chronic sore throats. Now only 20 percent are—80 percent are because infected tonsils are causing a child to have obstructive sleep apnea (OSA).

For repeated sore throats to be chronic enough to merit surgery, US guidelines say a child should have at least seven episodes in the previous year; five each year for two years; or three each year for three years. For OSA diagnosis, anecdotal evidence from parents and a doctor’s clinical observations are most often relied on to determine if a tonsillectomy is needed.

You don’t want your child to undergo this surgery unnecessarily. One study found between 3 and 13 percent of kids end up back in the hospital or ER post-tonsillectomy.

So if your child contends with chronic sore throats or is having sleep problems because their breathing is affected by swollen tonsils, have them evaluated by an experienced ear, nose and throat specialist who can help determine if surgery is really needed.

Medically reviewed in January 2020.

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