Are young children still candidates for tonsillectomy?

Background Clinical guidelines und the scientific literature support the idea, that tonsillotomy has widely replaced tonsillectomy for the surgical management of diseases related to the tonsils, at least in children. This study was undertaken to verify whether or not pediatric tonsillectomy has been erased from the surgical schedule in Germany.

Methods This longitudinal population-based cohort study was based on a bespoke report commissioned by the authors from the Germany Federal Office for Statistics. The database was interrogated for all patients who had undergone tonsillectomy, with or without adenoidectomy (code 5-282.0; 5-281.0) between 2005 and 2018. The population was stratified by age (<1 year, <5 year, <10 year) and by gender.

Results A total of 326.124 interventions encompassed 232.625 adenotonsillectomies and 93.499 tonsillectomies with a male preponderance (m:f 1,28). Children under the age of 1 year were extremely rare candidates for surgery with 3 interventions per year (median). Despite the significant (>80 %) decline of tonsillectomy cases in children the other 2 subgroups (< 5 y; < 10y) there were still 659 (<5 y) and 1.464 (<10 y) children having undergone TE in 2018, respectively. The decline in the number of adenotonsillectomies was less (74 % <5 years; 82 % <10 years), but there were still 3.093 (< 5y) and 2.785 (<10 y) interventions registered in 2018.

Conclusion It can be concluded from our study, that a considerable number of pediatric patients still undergoes tonsillectomy, with or without adenoidectomy, even if they are younger than 10 years of age. In 2018, a total of 8.006 tonsillectomy procedures resulted in 500 interventions per Federal State on average.

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Publication History

Article published online:
10 June 2020