Removing kids’ tonsils often not very helpful

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For children with mild throat infections or enlarged tonsils or adenoids, surgery to remove the offending tissues offers no major clinical benefits over a watchful wait-and-see approach, according to a Dutch study.

The findings are based on a study of 300 children who were candidates for adenotonsillectomy because of recurrent throat infections—more than seven episodes in the preceding year—or because they had enlarged tonsils and/or adenoids. 

The kids were randomly assigned to undergo surgery or be followed with a watchful waiting strategy, Dr. Anne G. M. Schilder, from University Medical Center Utrecht, and colleagues note in this week’s online issue of the British Medical Journal.

After an average follow-up of 22 months, the number of fever episodes in the surgery group was nearly the same as in the watchful waiting group. Subjects in the surgery and watchful waiting groups averaged 0.6 and 0.8 throat infections per person per year, respectively.

Although improvements in quality of life seen with tonsillectomy were significant from a statistical standpoint, they were not considered clinically relevant, the investigators note.

Also, there was evidence that surgery was more effective for children with three to six throat infections per year, rather than two or fewer.

The results indicate that surgery offers little benefit to children like those in this study, but it does marginally reduce “the number of episodes of fever, throat infections, and upper respiratory tract infections per person year,” the researchers conclude.

SOURCE: British Medical Journal, September 11th online issue, 2004.

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