Bottom Line: Removing tonsils and adenoids in children in Denmark was associated with increased long-term risk of respiratory, infectious and allergic diseases.
Why The Research Is Interesting: Tonsils and adenoids are commonly removed in childhood to treat conditions such as chronic ear infections and obstructed breathing. They are part of the immune system and are usually removed at ages when the development of the immune system is sensitive. Not much is known about the long-term impact of those surgeries.
Who and When: Nearly 1.2 million children born in Denmark from 1979 to 1999
What (Study Measures): Tonsils or adenoids removed within a child's first nine years (exposures); risk of disease up to age 30 (outcomes); all disease diagnoses in the national health registries of Denmark.
How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and could not control all the natural differences that could explain the study findings.
Authors: Sean G. Byars, Ph.D., University of Melbourne, Australia, and coauthors
Results: "To our knowledge, this is 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 and large for some. We showed 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. The associations that we uncovered in the Danish population appear to warrant renewed evaluation of potential alternatives to surgery."
Study Limitations: Did not address risks of diseases in people over 30; researchers did not have large enough samples for rarer diseases to obtain reliable risk estimates
Study Conclusions: Study results suggest it is important to consider long-term risks when deciding whether to remove a child's tonsils or adenoids.
To Learn More: The full study is available on the For The Media website.
(doi:10.1001/jamaoto.2018.0614)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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