Adult tonsillectomy: Current indications and outcomes

Objective: Limited data exist with respect to the current prevalence of indications for tonsillectomy in adults. We sought to determine the indications for adult tonsillectomy and to identify factors associated with postoperative complications. Methods: The medical records of 361 adult patients who underwent tonsillectomy from 2001 to 2007 were reviewed. Results: Indications for surgery were chronic infection in 207 (57%) patients, upper airway obstruction secondary to tonsillar hypertrophy in 98 (27%) patients, and suspected neoplasm in 56 (16%) patients. Postoperative complications occurred in 54 (15%) cases with hemorrhage in 19 (5%) patients, followed by dehydration in 16 (4%) patients, and admission for postoperative oxygen desaturations in 9 (3%) patients. Hospitalization beyond 24 hours occurred in 18 (5%) cases, with emergency room visits for pain and dehydration in 16 (4%) patients, and readmission for pain control in 17 (5%) cases. Patients who underwent tonsillectomy for upper airway obstruction had an increased incidence of prolonged hospitalization or readmission (19% vs 6%; P = 0.01), whereas patients who underwent tonsillectomy for infection had an increased incidence of postoperative bleeding (6% vs 4%; P = 0.02). Conclusions: Chronic infection remains the most common indication for adult tonsillectomy in contrast to the pediatric population. Complication rates vary according to the indication for surgery.