Public release date: 19-Nov-2007
Dutch study suggests that among children with mild or moderate symptoms of throat infections, surgery to remove the tonsils may be more expensive but not necessarily more beneficial than watchful waiting, according to a report in the November issue of Archives of Otolaryngology–Head & Neck Surgery, one of the JAMA/Archives journals.
Tonsillectomy—removal of the tonsils—with or without removal of the adenoids (tissue at the back of the throat) is one of the most frequently performed surgical procedures on children, according to background information in the article. However, the number of procedures performed varies widely by country. In 1998, adenotonsillectomies were performed on 115 per 10,000 children in the Netherlands, 65 per 10,000 British children and 50 per 10,000 American children. This suggests that different indications for surgery are used in each country.
Erik Buskens, M.D., Ph.D., of University Medical Center Utrecht, Utrecht, the Netherlands, and colleagues conducted a clinical trial involving 300 children age 2 to 8 who were recommended for adenotonsillectomy between 2000 and 2003. A group of 151 children were randomly assigned to have surgery within six weeks, while 149 were assigned to watchful waiting, which involved close monitoring and additional interventions as necessary. Parents kept diaries of all the children’s upper respiratory tract symptoms, measured their temperature daily and recorded any costs associated with their care. Follow-up visits occurred after three, six, 12, 18 and 24 months.