Feature Article

Tonsil and adenoid disease in childhood

Feature Article

Tonsil and adenoid disease in childhood

SUCHITRA PARAMAESVARAN

Figures

© christy Krames
© christy Krames

Abstract

Recurrent tonsillitis and sleep-disordered breathing are common paediatric presentations in general practice. GPs are well placed to identify, manage and, when appropriate, refer children with diseases of the tonsils and adenoid to help improve quality of life.

Key Points

  • In the paediatric population, upper airway obstruction and recurrent tonsillitis are common presentations to general practice pertaining to tonsil and/or adenoid disease.
  • Children with recurrent tonsillitis may be considered for surgery if frequency and longevity criteria are met and documented. Modifying factors such as febrile convulsions, antibiotic allergy and time off school may be considered in children who do not meet these criteria for surgery.
  • Documenting each episode of tonsillitis in paediatric patients is recommended to help ascertain their eligibility for tonsillectomy.
  • Sleep-disordered breathing describes a spectrum of upper airway breathing disorders ranging from simple snoring to obstructive sleep apnoea syndrome (OSAS).
  • OSAS can severely impact on quality of life; therefore, distinguishing it from simple snoring is an important component of patient management.
  • General practitioners play an important role in identifying paediatric patients with diseases that relate to the tonsils and adenoid and referring them to the ENT surgeon if needed.