Tonsillectomy and adenoidectomy in children

Otorhinolaryngology, Primary care

Tonsillectomy and adenoidectomy in children

Otorhinolaryngology, Primary care
(Adeno)tonsillectomies and adenoidectomies can be useful interventions, but not for every child. Although they do not always provide benefit, they do provide risk of complications such as post-operative bleeding and pain.

After the revision of the guidelines in 2014, the number of (adeno)tonsillectomies and adenoidectomies already decreased, but they are still performed on a regular basis. In children with mild symptoms of pharyngitis, no difference was observed after six months between the group that underwent surgery (tonsillectomy and possibly adenoidectomy) compared to the group that received a wait-and-see policy. In addition, adenoidectomies are not effective when children only suffer from an upper respiratory tract infection. Both operations also expose the patient to risks: complications occur in 1.5% to 4.2% of the patients that undergo a tonsillectomy and in 1 in 250 children who undergo a adenoidectomy. This project aims to reduce the practice variation of these procedures in children.

Approach:

The project team will use monitoring and feedback to reduce the practice variation for both procedures in specialists active in hospital care. General practitioners will also receive feedback information. The parents of the patients will be more closely involved in the treatment decision making process by stimulating the use of decision aids and brochures.

‘After completion of the implementation of the quality cycle ‘removal of nose and throat tonsils in children’, the number of surgeries dropped by 30-40%’

Progress:

Starting
Expected intervention start date: winter 2019.
Expected duration: 1,5  years.

Learn more:

Contact us at info@doenoflaten.nl

Stakeholders:

Prof. Peter Paul van Benthem, MD, PhD

| Leids Universitair Medisch Centrum (LUMC)

J. van Munster

| Leids Universitair Medisch Centrum (LUMC)