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Toward Adenotonsillectomy in Children A Review for the General Pediatrician

David G. Ingram, MD1; Norman R. Friedman, MD2,3
[+] Author Affiliations
1Division of Pulmonary and Sleep Medicine, Children’s Mercy Hospital, Kansas City, Missouri
2Division of Pediatric Otolaryngology, Children’s Hospital Colorado, Aurora
3Department of Otolaryngology, University of Colorado School of Medicine, Aurora
JAMA Pediatr. 2015;169(12):1155-1161. doi:10.1001/jamapediatrics.2015.2016.
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Adenotonsillectomy is one of the most common surgical procedures performed in children, with more than half a million procedures performed annually. We provide a review of the procedure, including indications, contraindications, perioperative issues, and current controversies. A more in-depth discussion of indications for sleep-disordered breathing and recurrent throat infections is performed. We provide a reasonable approach to these conditions for the general pediatrician. Finally, we discuss selected areas of current controversies: the role of preoperative polysomnogram, postoperative weight gain, and effects on immune function.

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Approach to Common Indications for Adenotonsillectomy

A management pathway for children who may benefit from an adenotonsillectomy. GAS indicates group A streptococcus; PFAPA, periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis; and SDB, sleep-disordered breathing.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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