Paradise Criteria for Tonsillectomy

The Paradise criteria for tonsillectomy was given by AAO-HNS for tonsillectomy in paediatric and adolscent age group.

Minimum number of sore throat in a year

            Atleast 7 in the previous year

            OR Atleast 5 in each of two previous years

            OR Atleast 3 in each of three previous years

With Clinical feature of Sore throat along with atleast one of the following

            Fever > 100.9^oF (38.3^oC )

            OR Tender Cervical Lympadenopathy of size > 2 cm

            OR Tonsillar exudate

            OR Culture positive for GABH (Group A β Hemolytic Streptococcus)

With Administration of adequate dosing of ANTIBIOTIC for proven or suspected GABH infection. 

Know the difference between membranous tonsillitis and diptheria.

What are the causes of membranes over the tonsils?

Difference between adenoid and Tonsils.

Do you know how your examiner wants to hear the examination of oral cavity during your OSCE and Clinical Skills. Follow link.

Membrane over tonsil (Differential diagnoses)

Mnenomics
Membrane Above A Tonsils Can Vary from MILd To Dangerous.

Membranes
Above        Apthous Ulcer
A               Agranulocytosis
Tonsil       membranous Tonsillitis
Can          Candiasis
Vary         Vincents Angina
MILd       Malignancy
                 Infectious Mononucleosis
                 Leukemia
To            Trauma
Dangerous Diptheria

Do you know how your examiner wants to hear the examination of oral cavity during your OSCE and Clinical Skills. Follow link.

Paradise Criteria for Tonsillectomy 

Know the difference between membranous tonsillitis and diptheria.

Difference between adenoid and Tonsils.

Difference between Membranous Tonsillitis and Diptheria

What are the causes of membrane over the tonsils?

Feature	Membranous Tonsillitis	Diphtheria
Age	>5	2-5
Onset	Acute	Insidious
General Symptoms	More	Less
Odynophagia	More	Less
Temperature	High	Low
Tachycardia	Proportionate with temperature	Disproportionate
Tonsil	Enlarged and congested	Normal
Membrane	Bilateral	Unilateral
	Whitish Yellow	Gray
	Thick	Thin
	Limited to Tonsil	Extends beyond
	Easily removed	Bleeds on removal
Culture	GABH	Corynebacterium diphtheria
Lymphnode	Jugulodiagastric (Woods)	Generalised (Bull Neck)

Paradise Criteria for Tonsillectomy 

Know the difference between membranous tonsillitis and diptheria.

Difference between adenoid and Tonsils.

Do you know how your examiner wants to hear the examination of oral cavity during your OSCE and Clinical Skills. Follow link.

Difference between Adenoids and Tonsils

What are the causes of membranes over the tonsils?

Feature	Adenoid	Tonsils
Capsule	Non Capsulated	Semi Capsulated
Epithelial Lining	Ciliated columnar epithelium	Non Keratinised Statified Epithelium
Number	One	Two
Location	Nasopharynx	Oropharynx
Impressions	Vertical crypts and Clefts	Crypts
Growth Curve	Maximum at 6 and regresses by 20	Maximum at 8 and regresses by puberty
Lymphatic Vessels	Both Efferent and Afferent present	Only Afferent

Do you know how your examiner wants to hear the examination of oral cavity during your OSCE and Clinical Skills. Follow link.

Paradise Criteria for Tonsillectomy 

Know the difference between membranous tonsillitis and diptheria.

What are the causes of membranes over the tonsils?