pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

Tonsillectomy – indications

[A mother questions the necessity of a tonsillectomy recommended for malocclusion.]

(The actual question has been lost but was about a tonsillectomy which had been recommended by a dentist for malocclusion.)

In all of my years I’ve never seen, or heard of, a case where hypertrophied tonsils cause malocclusion.

You didn’t say how old your child is; however, I used to practice in a town where several patients of mine told me the same story about a particular ENT physician in our town (who took out tonsils more often than almost all other ENTs in the town put together).

He would look in the child’s mouth and drop his chart and exclaim “they’re as big a teenagers!” — the truth is that tonsils waste away with age and I’ve seen many many healthy 6 year olds with larger tonsils than most teenagers.

I believe you are right to be skeptical about the relationship – I am.

Unless a child’s tonsils meet in midline – causing solid food dysphagia – have a specific number of recurrent infections of a specific organism – or meet other well established guidelines, the risks of a tonsillectomy outweighs the benefits of their removal and is not deemed medically necessary… hope this helps

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