Paradise Criteria for Tonsillectomy in Children
Predicts which patients with recurring sore throat will benefit from tonsillectomy.
Use only in patients aged 1-18 years in whom tonsillectomy is being considered. Do not use in children with diabetes mellitus, cardiopulmonary disease, craniofacial disorders, congenital anomalies of the head/neck, sickle cell disease or other coagulopathies, or immunodeficiency disorders.
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If a patient meets the appropriate criteria, then tonsillectomy is recommended due to a modest reduction in the frequency and severity of recurrent throat infection for up to 2 years following surgery.
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If a patient does not meet the criteria, watchful waiting is recommended. The goal is to avoid surgery and the risk of complications in children who will likely derive no benefit from the procedure.
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In certain situations, children mildly or moderately affected by sore throat may benefit from tonsillectomy. This includes patients with multiple antibiotic allergies, peritonsillar abscess, and history or family history of rheumatic fever.
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Children who do not meet the criteria but who are affected by tonsillar hypertrophy and/or sleep-disordered breathing may also benefit from tonsillectomy. This is especially true if they suffer from comorbid conditions, including behavioral problems, poor school performance, nocturnal enuresis, and/or growth retardation.