New guidelines for the treatment of sore throat infections have been recommended in an effort to reduce the number of potentially unnecessary tonsillectomies given to children each year.
New evidence-based guidelines from the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) aim to provide better guidance to pediatric ear, nose, and throat physicians for determine if tonsillar removal is the appropriate treatment for patients with pain. throat infections
The guidelines also include recommendations for improving pre- and post-treatment care, as well as methods to improve counseling and education for families considering tonsillectomy surgery for their child.
A tonsillectomy is a surgical procedure in which both tonsils are removed from their location in the throat near the base of the tongue. Tonsillectomies are one of the most common surgical procedures performed in the United States; with more than half a million performed annually on children under 15 years of age.
Tonsils are most often removed due to frequent throat infections or sleep-disordered breathing (SDB). A tonsillectomy sometimes includes removal of the adenoids, a bulge of tissue located above the tonsils near the back of the nose, especially in TRS patients.
According to the new guidelines, children most likely to benefit from tonsillectomies are those with at least:
- Seven documented cases of severe throat infection in the course of one year.
- Five serious throat infections a year for two years in a row.
- Three serious throat infections a year for three consecutive years.
The new guidelines describe a patient who meets the criteria for a diagnosis of severe sore throat infection as one who tests positive for strep throat or has all of the following: Fever of 101 degrees Fahrenheit, swollen/tender neck glands, and a white covering over the tonsils. .
Children with frequent throat infections can usually recover adequately without removal of the tonsils. However, the AAO-HNSF emphasizes that children with less frequent or severe infections may still benefit from a tonsillectomy if factors such as allergy to antibiotics are present.
Other highlights included in the AAO-HNSF report:
- Obstructed breathing due to large tonsils can cause SDB, possibly leading to snoring, mouth breathing, pauses in breathing, or sleep apnea. A tonsillectomy could resolve delayed growth, poor performance in school, bedwetting, or other problems that children with TRS or large tonsils sometimes experience.
- Children with SDB who are obese or have related head and neck syndromes may require additional treatment after a tonsillectomy.
- Parents should be informed of appropriate pain management approaches for use in children after tonsillectomy surgery. Acceptable methods include drinking plenty of fluids and using acetaminophen or ibuprofen. Parents should also make sure they get updates from their children if they are experiencing any sore throats.
For more information on the best sore throat treatment for your child, consult your pediatric otolaryngologist.
