Tonsillectomies might put children at greater risk of chest bugs, study says

Could having a tonsillectomy or adenoidectomy as a child mean you are more likely to get respiratory infections as an adult? A large international study says yes.

The research has found children who have their tonsils or adenoids removed are up to three times more likely to contract respiratory diseases when they get older.

Researchers from the University of Melbourne looked at more than 1 million children under nine from Denmark who had the procedures, then followed them up until the age of 30.

Lead researcher Dr Sean Byars from the University of Melbourne said tonsils and adenoids played an important role in immune function, but until now there had been little research into the risks in later life of removing the organs.

Researchers found having tonsils out led to nearly triple the relative risk of upper respiratory tract diseases.

Having adenoids out almost doubled the relative risk of children developing chronic obstructive pulmonary disorder as adults.

“The long-term risks of these surgeries deserve careful consideration,” he said.

The authors said the results, “suggest the early life removal [of tonsils and adenoids] may slightly but significantly perturb processes important for later-life health”.

Dr Byars said given the tonsils and adenoids played a key role in the development of the immune system, it was “not surprising” their removal might increase the risk of later respiratory and infectious diseases.

About 48,000 tonsillectomies and adenoidectomies are performed in Australia every year.

The paper has just been published in the journal JAMA Otolaryngology Head and Neck Surgery.

A number of earlier studies found removing adenoids and tonsils did not affect a child’s immune system.
.

Experts urge caution with findings

Australian doctors said the findings would need to be replicated in other studies, to prove having tonsils or adenoids removed caused health problems in later life.

Professor Michael Abramson from Monash University said the study was observational, rather than definitive proof.

“The results of this study provide important information for surgeons and referring doctors to discuss with parents,” he said.

Professor Rob Loblay from Sydney’s Royal Prince Alfred Hospital urged people to be cautious in interpreting the conclusions.

“Fortunately, in recent decades the pendulum has swung right away from unnecessary tonsillectomies or adenoidectomies,” he said.

“It’s relatively uncommon to see a child who’s had one nowadays without there being a good indication.”

Paediatric ear, nose and throat surgeon, Associate Professor Dr David McIntosh, said a limitation of the study was that it compares a group of children that were unwell early in life to a group of children that were not.

“We need to compare children with the same condition in life and break the numbers down to see what effect surgery versus no surgery has,” he said.

“This is probably the most important distinction to be made. ”

He said untreated upper airway obstruction can lead to lifelong health problems.