Adult Tonsillitis

Adult Tonsillitis

As a rough rule of thumb, adults who have three or more episodes of infectious tonsillitis per year with severe symptoms should be seriously considered for tonsillectomy, and those who have more than four or five episodes per year should definitely be considered. A pattern of such infections year after year makes an even stronger case for the surgery.

The number of infections per year should not be the only guide, however: the decision should also focus on the severity of the symptoms. For example, patients who have only two or three infectious exacerbations per year but for whom each infection causes a full week of missed school or work should also be considered.

It is not necessary to document repeatedly positive streptococcal cultures, since the goal is not purely to eradicate streptococcal infection but rather to improve quality of life.

Tonsillectomy in adults with chronic tonsillitis or pharyngitis has somewhat fallen out of favor in the past few decades. The primary reason is an extrapolation from data in children—pediatric studies suggested that the previous indications for pediatric tonsillectomy were too loose and evidence was lacking that children truly benefit from tonsillectomy for infectious indications.