Removal of the tonsils (tonsillectomy) or tonsils and adenoids (adenotonsillectomy) were once commonplace procedures done to treat recurring throat infection and inflammation in childhood. The procedures are now primarily done when enlarged tonsils and/or adenoids block the nasal passage and make breathing and sleeping difficult.
Researchers from the United Kingdom wanted to determine how effective tonsillectomy (with and without adenoidectomy) was in reducing the number and severity of episodes of tonsillitis or sore throat in children and adults with chronic/recurrent acute tonsillitis. The systematic review, published in The Cochrane Database of Systematic Reviews, found that tonsillectomy or adenotonsillectomy may modestly reduce the number of episodes of sore throat and days with sore throat in children in the first year after surgery compared to non-surgical treatment.
About the Study
The systematic review included 7 randomized trials that compared tonsillectomy alone or in combination with adenoidectomy versus no surgery in 1,183 participants with chronic or recurrent acute tonsillitis. Five of the trials enrolled only children (987) and 2 of the trials enrolled only adults (156). All outcomes in children were reported at 1 year.
The study linked tonsillectomy or adenotonsillectomy in children to:
- Fewer episodes of sore throat
- Fewer sore throat days (about 5 days difference)
- Fewer days of absence from school (about 2 days difference)
How does this affect you?
A systematic review is considered a highly reliable form of research because it combines large pools of data. The higher the number of participants the more reliable the results are. However, the review is only as reliable as the studies that make it up. Randomized trials are a reliable form of research, but the trials included in this systematic review had multiple limitations, including a high loss of participants for follow-up which can impact the outcome.
The decision to have a tonsillectomy or adenotonsillectomy done on your child is not an easy one for parents to make. However, in cases where children have recurring tonsillitis, the procedures may provide some relief and avoid some of the complications of tonsillitis, such as difficulty breathing and swallowing as well as sleep disturbances. If your child has recurrent tonsillitis and other treatments have failed, talk to your child's doctor about whether tonsillectomy or adenotonsillectomy may help.
RESOURCES
American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org
Family Doctor—American Academy of Family Physicians http://www.familydoctor.org
References
Burton MJ, Glasziou PP, et al. Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev. 2014 Nov 19;11.
Tonsils and adenoids. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/tonsils-and-adenoids. Accessed February 11, 2015.
Tonsils and tonsillectomies. KidsHealth—Nemours Foundation website. Available at: http://kidshealth.org/teen/infections/common/tonsillectomy.html#cat20172. Updated May 2013. Accessed February 11, 2015.