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DAVID F. AUSTIN, MD
Idaho Falls, Idaho

Arch Otolaryngol Head Neck Surg. 1990;116(6):741.

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In Reply.—I wish to thank Dr Meredith for his kind statements. He has rightly pointed out that tonsillectomy and adenoidectomy are procedures that are properly indicated in many conditions. Chronic infection of the tonsils and adenoids leads to poor nutrition and growth, and to loss of resistance to acute intermittent infection. To see a child flourish after an indicated adenotonsillectomy is a significant reward. How to transmit this knowledge to our pediatric colleagues is a challenge facing our specialty.

The second point raised by Dr Meredith, the economic inequity of third-party reimbursement, is yet another challenge. The common feeling that adenotonsillectomy is a minor procedure, best performed as an outpatient, certainly contributes to this problem. Why is it that I approach a tonsillectomy-adenoidectomy with far more trepidation than a mastoidectomy?

I again thank Dr Meredith for raising these important considerations. . . . [Full Text PDF of this Article]

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