Paradise Criteria for Tonsillectomy
Evidence-based criteria for tonsillectomy in recurrent tonsillitis. Requires ≥7 episodes in 1 year, ≥5/year for 2 years, or ≥3/year for 3 years.
Score interpretation
Episode frequency or documentation does not meet the Paradise criteria for tonsillectomy.
→ Watchful waiting; treat acute episodes; document each episode and reassess. Refer to ENT for other indications (obstructive sleep apnoea, recurrent peritonsillar abscess).
Meets the Paradise frequency and documentation criteria for tonsillectomy.
→ Refer to ENT to discuss tonsillectomy; shared decision-making weighing surgical risks (including post-operative haemorrhage) against the burden of recurrent infection.
Interpretation bands for the Paradise Criteria. Apply clinical judgement and local guidance.
References
- Paradise JL et al. Efficacy of tonsillectomy for recurrent throat infection in severely affected children. N Engl J Med. 1984.
- NICE NG34. Tonsillectomy for recurrent tonsillitis in children. 2020.
Related
Curated clinical cross-links plus same-class fallbacks.
- Adult Upper Airway Obstruction (Stridor) · DAS 2015 unanticipated difficult airway; RCEM
- Epistaxis Management · ENT-UK / NICE
- Acute Otitis Media · NICE NG91 2018
- Tonsillitis and Sore Throat · NICE NG84 2018
- Benign Paroxysmal Positional Vertigo · NICE CG124 / AAO-HNS Guidelines
- Acute Rhinosinusitis · NICE NG79 2017 / EPOS 2020
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.