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Tonsillectomy Guidelines Could Reduce Kids' Surgeries

Parents and their child before a tonsillectomy at the Children's Hospital in Philidelphia in the 1950s i i

Parents and their child before a tonsillectomy at the Children's Hospital in Philidelphia in the 1950s Hulton Archive/Getty Images hide caption

itoggle caption Hulton Archive/Getty Images
Parents and their child before a tonsillectomy at the Children's Hospital in Philidelphia in the 1950s

Parents and their child before a tonsillectomy at the Children's Hospital in Philidelphia in the 1950s

Hulton Archive/Getty Images

So who do I see to get my tonsils back?

All right, I'm not sure I really want them returned because then I'm afraid I'd have to hand back the cool astronomy book my Mom brought me after the operation.

Still, in looking over new guidelines on when kids should have their tonsils removed — and when they shouldn't — I'm thinking I probably could have avoided the knife way back when.

More than 530,000 American kids get their tonsils out each year. And yet, until now, there hasn't been a systematic look in this country at when exactly a tonsillectomy is warranted. "There's a lot of controversy when to do surgery for tonsil infections and when not to," Dr. Sanford Archer, a surgeon at the University of Kentucky, told Shots.

Most kids do outgrow tonsil problems, after all. And any surgery, including tonsillectomy, carries risks as well as benefits.

So a bunch of experts convened by the American Academy of Otolaryngology-Head and Neck Surgery, including Archer, sifted through the medical evidence and put together the first solid U.S. guidelines on when to yank out tonsils and when to leave them be.

Kids usually get sent for tonsillectomy after a bunch of bad, sore throats. But how many is too many? The guideline gives this advice: If a kid has had fewer than seven throat infections in the past year, then it's probably a good idea to hold off on surgery.

If a kid has five or more throat infections a year for two years, then it's probably OK to get the tonsils out. Same goes for three or more in three years.

Also, if swollen tonsils are causing sleep apnea, then that's an independent reason to consider surgery regardless of infections.

Of course, there are exceptions and details to consider.But the guidelines give a better framework for a discussion between parents and doctors.

In case you're curious, the cost of an outpatient tonsillectomy ranges from around $3,000 to $5,000.

Archer told Shots, "I believe that if these guidelines are followed across the board we'll see a reduction in operations. And the ones done will be more justified."

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