Changes in incidence and indications of tonsillectomy and adenotonsillectomy, 1970-2005

Objective: To investigate 35-year epidemiological trends in tonsillectomy and adenotonsillectomy. Study Design/Subjects: Cross-sectional survey. Subjects included all patients from birth to age 29 years who had tonsillectomy or adenotonsillectomy from 1970 to 2005. Results: Study included 8106 patients (median age 8.0 years; range, 6 months to 29 years; male 3646 patients [45%]). Overall tonsillectomy incidence increased from 126 (95% confidence interval [CI], 111-140) per 100,000 person-years in 1970 through 1974 to 153 (95% CI, 139-166) in 2000 through 2005. A dominant factor, adenotonsillectomy incidence rose sharply from 243 (95% CI, 223-261) per 100,000 person-years in 1970 through 1974 to 485 (95% CI, 462-509) in 2000 through 2005. The indication of upper airway obstruction increased from 12 percent of patients in 1970 to 77 percent in 2005. Conclusions: Epidemiological trends in tonsillectomy and adenotonsillectomy have shifted substantially. Overall numbers have increased, and surgical indications have shifted from infection to upper airway obstruction.