The following surgical procedures are available:
- Tonsillotomy (TT) – surgical removal of the palatine tonsils [favored in children between the ages of three and six].
- Subtotal (“not complete”)/intracapsular (“within the capsule”)/partial (“partial”) tonsillectomy (SIPT) available.
To date, no advantage has been demonstrated for any of the procedures.
Indications for extracapsular tonsillectomy.
- ≥ 6 episodes of tonsillitis per year: tonsillectomy is a therapeutic option.
- 3-5 episodes of tonsillitis in a year: tonsillectomy is a possible option if further episodes should occur within the next 6 months and the number 6 is reached
Other indications include:
- Peritonsillar abscess (PTA) – spread of inflammation to the connective tissue between tonsil (tonsils) and M. constrictor pharyngis with subsequent abscessation (accumulation of pus).
- Severely enlarged palatine tonsils in children, which impedes breathing.
- Multiple antibiotic allergies that make inflammatory therapy impossible PFAPA syndrome (PFAPA stands for: periodic fever, aphthous stomatitis (inflammation of the oral mucosa), pharyngitis (pharyngitis), cervical adenitis) – rare disease with typical, fairly uniform course of symptoms: episodes of fever. Which usually manifest themselves before the age of five; these begin very regularly every 3-8 weeks with abruptly rising fever > 39 ° C, which spontaneously recedes after 3-6 days.
Tonsillotomy indication for recurrent tonsillitis of children and adolescents:
- Tonsil size greater than Brodsky grade 1 (narrowing of oropharyngeal diameter by ≥ 25%); and
- Number of episodes in the previous year (3-5 = possible option, ≥ 6 = therapeutic option).
For more details on tonsillotomy or tonsillectomy, see surgeries of the same name.
