What are the AAO-HNSF guidelines on tonsillectomy for tonsillitis and peritonsillar abscess (PTA)?

Updated: Apr 06, 2020
  • Author: Udayan K Shah, MD, FACS, FAAP; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

The 2011 clinical practice guidelines on tonsillectomy in children released by the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) offers the following recommendations [19] :

  • If there have been fewer than seven episodes of recurrent throat infection in the past year or fewer than five episodes per year in the past 2 years or fewer than three episodes per year in the past 3 years, watchful waiting is preferred over tonsillectomy
  • Tonsillectomy is indicated for recurrent throat infection of at least seven episodes in the past year or at least five episodes per year for 2 years or at least three episodes per year for 3 years with documentation of one or more of the following: temperature above 38.3°C, cervical adenopathy, tonsillar exudate, and/or positive test for Group A β-hemolytic streptococcus (GABHS)
  • Tonsillectomy may be considered in children who do not meet the above criteria but have multiple antibiotic allergies/intolerances, PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and adenitis), or a history of peritonsillar abscess

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