Tonsillectomies! To do or not to do, that is the question

Tonsillectomies have long been the 'bread and butter' of the ENT surgeons. When they are indicated, they are a great help for the kids and parents, however it has been seen that a lot many tonsillectomies are NOT NECESSARY!
So how do we decide when a tonsillectomy is indicated?
A tonsillectomy is generally done for recurrent 'sore throat' or throat infections. However in most children it has been shown that there is no significant decrease in the number of Upper respiratory infections (URI) after undergoing tonsillectomies (Sept 11, 2004, BMJ).

Only those children who get a documented (seen by a doctor, preferably)
attack of URI of 6-7 times in 1 year, or 5 episodes per year for 2
consecutive years, or 3 episodes per year for 3 consecutive years should
probably be taken up for tonsillectomy.

Among other reasons for tonsillectomies would be extremely large tonsils interfering with sleep (Obstructive Sleep Apnoea) detected by snoring, irregular sleep, daytime sleepiness, and mouth breathing. Also if a child has very severe URI's with long lasting symptoms tonsillectomy may be undertaken sooner