Indications for tonsillectomy

Tonsillitis – Tonsils are enlarged with pus visible in the crypts

Tonsillectomy is the process by which the tonsils are removed from the tonsillar fossa. The indications for tonsillectomy are:

1. Absolute indications
   1. Recurrent attacks of tonsillitis
      • More than 7 times a year for one year
      • More than 5 times a year for 2 years
      • More than 3 times a year for 3 years
      • More 2 weeks of school or work lost due to tonsillitis in a year
   2. Peritonsillar abscess (quinsy)
      • In children, tonsillitis is done 4-6 weeks after resolution of a peritonsillar abscess
      • In adults tonsillectomy is done after the second attack of peritonsillar abscess
   3. Enlarged tonsil causing obstructive symptoms
      • Difficulty in respiration
      • Diffuculty in swallowing
      • Difficulty in speaking
   4. Febrile seizures in children
   5. Suspected tonsillar malignancy
2. Relative indications
   1. Streptococcal carriers
   2. Diphtheria carriers
   3. Chronic tonsillitis causing halitosis
   4. Recurrent streptococcal tonsillitis in a patient with valvular heart disease
3. As part of other surgical procedures
   1. Removal of styloid process in Eagle’s syndrome
   2. Glossopharyngeal neurectomy
   3. Palatopharyngoplasty in sleep apnoea syndrome

Appearance of tonsillar fossa 3 days after tonsillectomy

Image by Jmh649