Indications for Adenotonsillectomy

High on most lists of "unnecessary surgery" is adenotonsillectomy, commonly calledT & A. Although recent work1has clearly established the efficacy of tonsillectomy for severely affected children after years of anecdotal experience have pointed toward its effectiveness, the operation still receives much bad press. Unfairly, we think. Over the past 50 years, medical attitudes on the necessity for removal of the tonsils and adenoid in children have varied from routine removal in the preantibiotic era, to no removal in the 1970s, to, hopefully, a more rational approach for selected cases in the 1980s. The wide-ranging and intense controversies expressed in the literature about the indications and benefits of adenotonsillectomy have been fueled by limited data and socioeconomic overtones. The tonsils and adenoid consist of lymphoid follicles and an overlying epithelium that is folded inward to form crypts. Similar tissue can be identified at the base of the tongue