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Tonsillectomy, adenoidectomy in childhood increases respiratory risks later

Tonsillectomy, adenoidectomy in childhood increases respiratory risks later

Adenoidectomy and tonsillectomy in childhood might increase long-term risks for respiratory and infectious diseases, according to a study recently published in JAMA Otolaryngology-Head & Neck Surgery.

Tonsillectomy and adenoidectomy are surgical procedures performed to remove the tonsils and adenoids. The tonsils and adenoids are masses of lymphoid tissue located behind the nasal passages.

Adenoids and tonsils are commonly removed in childhood which are parts of the immune system and has known roles in pathogen detection and defense and is usually removed at ages when the development of the immune system is sensitive. Though tonsillectomy and adenoidectomy are common pediatric procedures to treat obstructed breathing or recurrent middle-ear infections, little is known about their long-term health consequences.

Sean G. Byars and his associates conducted a study to assess the long-term disease risks associated with adenoidectomy, tonsillectomy, and adenotonsillectomy during the first nine years of life as a child.

The population-based cohort study included 1,189,061 children born between 1979 and 1999 and incidence of disease was examined up to age 30 years.

Key findings of the study:

  • Tonsillectomy was associated with an absolute risk increase of 19% for upper respiratory tract diseases; with adenoidectomy, the absolute risk increase was 11%.
  • Adenotonsillectomy was associated with an absolute risk increase of 2% for infectious diseases.
  • The long-term benefits of these surgeries, meanwhile, were deemed “minor.”

The authors concluded that this was the first study to estimate long-term disease associations with early-life tonsillectomies and adenoidectomies for a broad range of diseases. Risks were significant for many diseases.

The study suggested that absolute risks and the number of patients needed to treat before enhanced health risks later in life become apparent were more consistent and widespread than the immediate population-wide benefits of childhood surgery for subsequent health within the first 30 years of life.

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Source: With inputs from JAMA Otolaryngology-Head & Neck Surgery

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  1. user
    Dr Mohammad Abu Bashar July 3, 2018, 7:15 am

    Of course, those who are allergic would have chronic tonsillitis..selection bias is a major demerit of these types of studies

  2. This is a biased study.
    Considering the fact that tonsillectomy is performed in patients who are already prone to upper respiratory tract infections and allergies compared to those who did not undergo that procedure, The later life increase in incidence of Upper respiratory tract disease has to be expected due to selection bias.

  3. You are right. Also, adenoids and tonsils that cause obstructive sleep apnea cannot be left untreated. Not operating will mean stunted growth, ADHD, obesity, and left heart failure.