Tonsillectomy

A tonsillectomy is the excision of one or both tonsils.

Note:

• there is evidence from a study by Van Staaij and colleagues (1) that immediate surgery (adenotonsillectomy) did not reduce episodes of fever, throat infections, upper respiratory tract infections, and health related quality of life
  • study randomising 300 children aged 2-8 years with these symptoms to adenotonsillectomy or watchful waiting
  • median follow up period of 22 months
    • adenotonsillectomy was more effective in children who had three to six throat infections than in those who had up to two
    • twelve children had complications after surgery
  • Little, in a BMJ commentary, points out that a third of children initially treated medically required surgery (2)
    • this study provides evidence that immediate surgery is not effective, not that tonsillectomy in itself is ineffective, but more data are needed to optimise treatment (2)

Reference:

1. Van Staaij et al (2004). Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy: open, randomised controlled trial. BMJ;329:651
2. BMJ 2004; 329: 654