Appropriateness and safety of tonsillectomy and/or adenoidectomy - 2008

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Summary

Introduction

• History
• Epidemiology
• Objectives and audience of the guideline

Methods

• Workgroup
• Literature search
• Data mining, evidence summary and formulation of recommendations
• External review
• Dissemination and implementation, monitoring, evaluation and update
• Annexes and availability of full text

Indications to tonsillectomy and/or adenoidectomy

• Obstructive sleep apnea due to adenotonsillar hypertrophy in children
• Recurrent tonsillitis
• Peritonsillar abscess
• PFAPA syndrome
• Recurrent acute otitis media and chronic otitis media with effusion
• Recurrent or chronic rhino-sinusitis

Surgical techniques

• Dissection versus diathermy
• Coblation
• Ultrasonic harmonic scalpel (ultracision)
• Other surgical techniques
• Intracapsular techniques
• Adenoidectomy

Perioperative management

• Preoperative tests
• Anesthesiological techniques
• Postoperative monitoring of OSAS children
• Perioperative use of antibiotics
• Prophylaxis for bleeding
• Prophylaxis and treatment of postoperative pain and vomiting
• Postoperative complications

Clinical and organizational aspects of adenotonsillectomy

• Healthcare
• Informed consent
• Characteristics of hospitalization in children
• Role of the family pediatrician and general practitioner

Bibliography