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Tonsillectomy, or removal of the tonsils, is the most common
major surgery performed on children in the U.S. In 1996, nearly
300,000 children under age 15 underwent some form of tonsillectomy
to prevent serious or recurring infections. This surgery
has been around forever, and is proven effective for children
with severe, recurrent throat infections. Yet insufficient
evidence supports this procedure in children with only moderate
infections.
In a study at the Children's Hospital of Pittsburgh, over
300 children ages 3-15 were utilized based on the determination
that they suffered from throat infections to a greater degree
than recommended for surgery under current guidelines, but
to a lesser degree than children in previous studies on the
effectiveness of tonsil removal. Children received either
no surgery or one of two forms of tonsillectomy.
 Although surgery groups showed lower rates of throat infection
than nonsurgery groups over the three years after surgery,
rates of moderate-to-severe infection were still considered
"low" in nonsurgery groups. Also, despite a slightly lower
infection rate, nearly 10% of the children who had surgery
developed complications.
Under current guidelines, it appears that too many tonsillectomies
are being authorized. The authors of this study in Pediatrics
conclude that the relatively insignificant advantage
currently gained from tonsillectomies in moderately affected
children does not justify the risks, pain, and financial costs
involved.
Reference:
Paradise JL, Bluestone CD, Colborn DK, et al. Tonsillectomy
and adenotonsillectomy for recurrent throat infection in moderately
affected children. Pediatrics 2002:110(1), pp. 7-15.
For more information about pediatric health, check out https://www.chiroweb.com/find/archives/pediatrics.
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