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Tonsil surgery may be ineffective in children

Physician Practice Advisor, September 14, 2004

For children with mild throat infections or enlarged tonsils or adenoids, surgery offers no major clinical benefits over a wait-and-see approach, according to the September 11 online issue of the British Medical Journal.

These findings are based on a Dutch study of 300 children who were candidates for adenotonsillectomy because of recurrent throat infections (more than seven in one year) or because they had enlarged tonsils and/or adenoids. According to the researchers, the patients were randomly assigned to undergo surgery or be followed with a watchful waiting strategy.

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, researchers did not consider them clinically relevant. The results indicate that surgery offers little benefit to children such as 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 concluded.

Go to bmj.bmjjournals.com to read the full article.

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