After having reviewed the literature the authors advise adenotonsillectomy for the following groups: Those few children with cor pulmonale and right-sided heart failure secondary to enlarged adenoids and tonsils. Those children with enlarged adenoids causing hyponasality and disorders of speech and occlusion when operation is recommended or agreed to by dentists, oral surgeons, or speech pathologists. Those children with 3 or more genuine episodes of exudative tonsillitis in a year, persistent abnormal bacterial microflora of the oropharynx and nasopharynx and/or elevated levels of IgG and IgA. Those children with persistent non-suppurative otitis media with no systemic immunological or metabolic deficit and no allergic disorder, but who carry a persistent abnormal bacterial microflora of the oropharynx and nasopharynx. These indications led to a total of 94 adenotonsillectomies in 1975 at West Virginia University Medical Center, a general hospital of 450 beds whose otolaryngology service had 12 000 outpatient visits during the same year. The evaluation of adenoidectomy has only been studied by the authors in order to say that bacterial microflora is normalized best by adenotonsillectomy. Clinical evidence of others suggests that this is an alternative that works to the advantage of the host, but the authors are unaware of the exact indications.
|Original language||English (US)|
|Number of pages||15|
|State||Published - 1977|
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