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Tonsillectomies, adenoidectomies increase risk of later disease in children
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Pediatric tonsillectomies and adenoidectomies increase the risk of upper respiratory tract diseases and slightly increase the risk for other infectious and allergic diseases, according to research published in JAMA Otolaryngolgy-Head & Neck Surgery.
“[Our] observed results that show increased risks for long-term diseases after surgery support delaying tonsil and adenoid removal if possible, which could aid normal immune system development in childhood and reduce these possible later-life disease risks,” Sean G. Byars, PhD, from Melbourne Integrative Genomics at the University of Melbourne and the Center for Social Evolution in the department of biology at the University of Copenhagen, Denmark, said in a press release.
To approximate the long-term health risks associated with adenoidectomy, tonsillectomy and adenotonsillectomy in pediatric patients, the researchers conducted a population-based cohort study that included children born in Denmark between 1979 and 1999. These children were followed for up to 30 years. The health of participants in both the case group and the control group was similar prior to surgery. All procedures were performed by the time participants reached 9 years of age.
Of the 1,189,061 children included in the study, 17,460 underwent adenoidectomies, 11,830 underwent tonsillectomies and 31,377 underwent adenotonsillectomies. Most of these surgeries (n = 1,157,684) were performed within the control group.
When children underwent adenoidectomy, their risk of upper respiratory diseases increased two-fold (RR = 1.99; 95% CI, 1.51-2.63). A nearly three-fold risk of upper respiratory disease was observed for children who underwent tonsillectomy (RR = 2.72; 95% CI, 1.54-4.80).
Additionally, children who underwent either procedure were at a slightly increased risk of allergic and infectious diseases, with adenotonsillectomy patients at a 17% increased risk for infectious diseases (RR, 1.17; 95% CI, 1.10-1.25). The researchers wrote that because the diseases were relatively common in the population (12%), the absolute risk increase of infectious disease was calculated at 2.14%.
When Byars and colleagues examined whether these procedures affected the long-term risks of developing the conditions the surgeries are used to prevent, no significant difference was observed between the two groups. At times, the risk would be sometimes higher or lower.
“As we uncover more about the function of immune tissues and the lifelong consequences of their removal, especially during sensitive ages when the body is developing, this will hopefully help guide treatment decisions for parents and doctors,” Byars said in the release. – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.
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