Seven out of 8 children may not benefit from tonsillectomy

Researchers analyzed the electronic medical records of over 1.6 million children from more than 700 UK general practices dating between 2005 and 2016. They found that out of 18,271 children who had tonsillectomy during this time, only 2,144 (11.7 percent) had enough sore throats to justify surgery.

The researchers at the University's Institute of Applied Health Research concluded that their evidence, published today (Nov 6th) in British Journal of General Practice, showed that annually 32,500 children undergo needless tonsillectomies at a cost to the NHS of £36.9 million.

What's more, they found that many children who might benefit from having tonsillectomy are not having the surgical procedure. They found that of 15,764 children who had records showing sufficient sore throats to undergo a tonsillectomy, just 2,144 (13.6 percent) actually went on to have one.

Current UK health policy, based on the best scientific evidence, is that to meet the criteria to benefit from a tonsillectomy children must suffer from either more than seven documented sore throats in a year; more than five sore throats per year for two successive years; or three sore throats per year for three successive years.

The researchers found that, of those who had undergone a tonsillectomy, 12.4 percent had reported five to six sore throats in a year; 44.7 percent had suffered two to four sore throats in a year, and 9.9 percent had just one sore throat in a year.

Tom Marshall, Professor or Public Health and Primary Care at the University of Birmingham, said: "Research shows that children with frequent sore throats usually suffer fewer sore throats over the next year or two. In those children with enough documented sore throats, the improvement is slightly quicker after tonsillectomy, which means surgery is justified.

"But research suggests children with fewer sore throats don't benefit enough to justify surgery because the sore throats tend to go away anyway.

"Our research showed that most children who had their tonsils removed weren't severely enough affected to justify treatment, while on the other hand, most children who were severely enough affected with frequent sore throats did not have their tonsils removed. The pattern changed little over the 12 year period.

"Children may be more harmed than helped by a tonsillectomy. We found that even among severely affected children only a tiny minority of ever have their tonsils out. It makes you wonder if tonsillectomy ever really essential in any child."