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Recommendation Strength Referral for tonsillectomy is appropriate for children having 7 bouts of tonsillitis in 12 months, 5 annual bouts for 2 years, or 3 annual bouts for 3 years. Watchful waiting is indicated for lesser frequency. SORT: A1 Tonsillectomy may reasonably be offered to children having fewer infections given certain modifying factors. SORT: B1 Tonsillectomy or adenotonsillectomy should be recommended for pediatric obstructive sleep - disordered breathing felt due to adenoid or tonsillar hypertrophy. SORT: A1 Tonsillectomy has shown benefit for adults with recurrent tonsillitis. SORT: B2,3 Tonsillectomy/adenotonsillectomy may be indicated in adults with sleep disordered breathing and tonsil hypertrophy. SORT: C4 Adenoidectomy may be considered for chronic middle ear effusion and recurrent otitis media in children. SORT: B5–8 Tonsillectomy may be considered for poorly validated indications such as chronic tonsillitis, febrile seizures, muffled speech, halitosis, malocclusion, tonsillar hypertrophy, cryptic tonsils, and chronic pharyngeal carriage of group A β hemolytic Streptococcus (GABHS). SORT: C1 SORT, Strength of Recommendation Taxonomy