Tonsillectomy is the commonest reason for admitting children to hospital, and about 30% of admissions under the age of 15 years are for this operation. These cost the Health Service about £3 million a year. For about 10% of patients admitted for tonsillectomy the indications are clear, including frequent and severe episodes of tonsillitis for several years despite antibiotic therapy.1 For the rest the indications are uncertain, and greatly influenced by fashions, both parental and medical, by the available facilities and by the preoccupations and enthusiasms of the ENT surgeons who control them. Thus, in 1958 the proportion of school children aged 14 years who had been operated on was 1.4% in Shropshire, 43. 2% in Huntingdonshire, 2. 8% in Manchester and 18. 7% in Salford,2 a few miles away.
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