Guidelines for tonsilectomy changes- published Jan. 2011

[colleenrn]

I thought I should post this for families who are considering T&A or may be for the future. The guidelines have changed and were just posted in this journal. It seems to me that it may be harder to get a T&A for your child. I am NOT liking these new recommendations at all.

 

http://oto.sagepub.com/content/144/1_suppl/S1.full

 

What I thought was interesting, and not in the best interest of children with PANDAS, is a few of the changes such as needing more infections to do a T&A. Also they are recommending not giving any perioperative antibiotics.

 

This link is an article that talks about these new guidelines that just came out this week.

 

http://www.post-gazette.com/pg/11006/1115870-114.stm#ixzz1AfLmBBbK

 

"Under the new guidelines, children who are candidates for surgery for recurrent throat infections should have at least seven documented infections in one year, five infections in each of two consecutive years or three infections in each of three consecutive years.

 

Moreover, to be diagnosed with a bona fide throat infection, the child should have a temperature of 100.9 degrees Fahrenheit, a white covering over the tonsils, enlarged lymph nodes in the neck or a positive test for a strep throat."

Colleen

[SarahJane]

Thanks for sharing this...VERY interesting to read! You'd think that they'd give abx if there's an infection in the tonsils anyway. That makes no sense to me. Guess since they're usually cauterizing for removal that they think there's no infection escaping. And I wish I'd thought about something like these guidelines even existing when we had my ds's adenoids out when he was almost 3 due to sleep disturbance & behavior/dev questions. Dr didn't take the tonsils because they weren't big enough (even tho' my husband had T&A as a child), but then our son got sick & basically stayed sick off & on for 1.5 yrs. Then there was chronic tonsillitis (never tested positive for strep then tho'--when they even bothered to test) & the hypertrophic tonsils were removed when he was 4.5. Great period of health & no big behavior issues until...strep came 1.5 years later & big PANDAS exacerbation. (Now we figure the behavior stuff we were seeing from 3-4.5 was PANDAS vs. it starting last year). Reading these guidelines makes it seem like a T&A woulda been a no-brainer from the beginning & I could have argued for it. (Honestly tho', we had A LOT going on during that time & the surgery was just one of many stressors, so my brain wasn't functioning at full speed.) AND if he hadn't been sick all that time, would the PANDAS have even happened. More to wonder about and a big can of worms opened. Grrrrrrrr.

 

This was really interesting. Thanks again!