Table 1.

Practice Recommendations with SORT Strengths1

RecommendationStrength
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: B58
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