STUDY: Surgery to remove a child's tonsils or adenoids may be unjustified

JOURNAL: Pediatrics 2002;110:7-15

AUTHORS: Dr. Jack L. Paradise

ABSTRACT: Surgery to remove a child's tonsils or adenoids may be unjustified if the child's recurrent throat infections are less than severe, new study findings suggest.

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COMMENTARY: Children who haven't had a lot of trouble with their tonsils should not have surgery. It's not free of risk and it's a relatively major operation.

Paradise and his colleagues studied 328 children aged 3 to 15 who suffered repeated throat infections to determine whether or not tonsillectomy was always warranted. Because most tonsil removal operations also involve the removal of the child's adenoids, they examined whether this additional operation provided greater benefit.

The children were divided into two groups, which consisted of 151 children who had recurrent ear infections and obstructed nasal passages, indicating a need to have their adenoids removed, and 177 children without such symptoms.

Overall, the children who underwent surgery had lower rates of later throat infections than did children in a comparison group who did not have surgery, the investigators report in the July issue of Pediatrics. However, their overall rates of moderate or severe infections were relatively low, the researchers note.

For example, in any given year of follow-up, 70% to 84% of children in the two study groups did not experience any throat infections. And over the 3 years of follow-up only about 11% of the throat infections were moderate or severe.

Furthermore, adenoid removal surgery was of no additional benefit, the authors point out.

"Like any other operation in medicine (adenoid removal surgery) is useful for selected patients but shouldn't be done for children who don't need it," Paradise said.

Roughly 8% of the 203 children who had their tonsils or their tonsils and adenoids surgically removed experienced hemorrhage, red rashes or some other type of complication either during or after surgery, the report indicates.

In light of the findings, Paradise advises parents not to rush to have their child's tonsils removed. "Make sure the children are really having a lot of difficulty because most children tend to outgrow their symptoms," he said.

Here at the clinic we treat many children with great success.