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December 1986


Author Affiliations

San Antonio, Tex

Arch Otolaryngol Head Neck Surg. 1986;112(12):1301. doi:10.1001/archotol.1986.03780120065016

In Reply.—We appreciate and agree with the comments of Parell and colleagues regarding the efficacy of adenotonsillectomy for the relief of chronic upper airway obstruction, which, as we noted,1 was the only unequivocal indication for the procedure.

We are pleased to note Horton's assurance that pediatricians do recognize the utility of tonsillectomy for recurrent throat infections. His criticisms highlight many of the semantic controversies that arise when the subject of adenotonsillectomy is discussed among surgical and nonsurgical specialists. Patients suffering from frequently recurring sore throat may have more than one underlying cause for their symptoms. Some episodes are streptococcal in origin, some are not. Therefore, to limit surgical treatment to proven streptococcal infections may preclude treatment for those who need it most. In the landmark study by Paradise et al,2 this problem was solved by use of clear-cut clinical—not microbiological—criteria for admission of children with nontrivial throat