Current Indications and Outcomes of the Adult Tonsillectomy

Abstract

Objective: While there have been numerous studies on tonsillectomies for the pediatric population, there are few studies focused on tonsillectomies performed on adult patients. We sought to determine the current indications for adult tonsillectomy and to examine factors associated with postoperative complications.

Method: Medical records of 184 patients aged >18 years who underwent tonsillectomy in an academic general otolaryngology practice from 2006 to 2011 were retrospectively reviewed. There were 185 tonsillectomies performed (149 total tonsillectomies [TT] and 36 partial intracapsular tonsillectomies [PIT]); 1 patient underwent primary and revision tonsillectomy.

Results: Indications for TT were 58.4% infection (71.3% recurrent, 9.2% tonsilliths/halitosis, and 19.5% recurrent and tonsilliths/halitosis), 34.2% upper airway obstruction, 3.4% obstruction/infection, and 4.0% other medical. Indications for PIT were 77.8% infection (28.6% recurrent, 50.0% tonsilliths/halitosis, and 21.4% recurrent and tonsilliths/halitosis), 19.4% upper airway obstruction, and 2.8% obstruction/infection. Complication rates were 16.5% for infection, 6.9% for upper airway obstruction, 16.7% for obstruction and infection, and 0% for other medical reasons. Complications occurred in 14.8% of TT (72.7% hemorrhage, 27.3% dehydration) and in 5.6% PIT (hemorrhage). No significant difference in complication rate was noted for technique (P = .17) or indication (P = .21).

Conclusion: While recurrent infection remains the most common indication for adult tonsillectomy, there is a growing rate of tonsillectomies performed for upper airway obstruction. Complication rates varied according to indication for surgery and surgical technique (total versus partial intracapsular); however, neither was found to significantly increase risk of postoperative complications.