Best of five
- A. Tonsil size alone
- B. A single positive throat swab
- C. Parental request without clinical assessment
- D. Routine CT of the neck
- E. Documented frequency, severity, functional impact and shared discussion of operative risks
FRCS (ORL-HNS) · SECTION 1 SBA
Recurrent throat infection and tonsillectomy
A child is being considered for tonsillectomy because of recurrent sore throats. Which factor is most important before recommending surgery?
E. Documented frequency, severity, functional impact and shared discussion of operative risks
Tonsillectomy decisions require credible episode documentation and assessment of impact, alternatives and perioperative risks. A numerical threshold should not replace clinical context or shared decision-making.
Why every option is right or wrong
A. Tonsil size alone: Large tonsils without obstructive or infective morbidity do not establish benefit from surgery.
B. A single positive throat swab: One microbiological result does not demonstrate recurrent clinically significant tonsillitis.
C. Parental request without clinical assessment: Family preferences matter but must be supported by a balanced evidence and risk discussion.
D. Routine CT of the neck: Imaging is unnecessary for uncomplicated recurrent tonsillitis.
E. Documented frequency, severity, functional impact and shared discussion of operative risks: Tonsillectomy decisions require credible episode documentation and assessment of impact, alternatives and perioperative risks. A numerical threshold should not replace clinical context or shared decision-making.
What if the scenario changed?
If the child had obstructive sleep-disordered breathing with growth or cardiopulmonary consequences, the indication and preoperative assessment would be different.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for local policy and specialist judgement.
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