Researchers of a new study looked at the long-term health risks associated with removing tonsils and adenoids in children, and found that these procedures were associated with increased long-term risk of respiratory, infectious, and allergic disease (JAMA Otolaryngol Head Neck Surg. Published online June 7, 2018. doi:10.1001/jamaoto.2018.0614).
The investigators analyzed data on nearly 1.2 million children (48% female) born in Denmark between 1979 and 1999 who were followed up to age 30. Of those, 17,460 underwent adenoidectomy, 11,830 tonsillectomy, and 31,377 adenotonsillectomy, all before age 9. The remaining participants (1,157,684) served as controls.
Adenoidectomy and tonsillectomy were associated with a two- to three-fold increase in diseases of the upper respiratory tract (RR = 1.99 and RR = 2.72, respectively). Smaller increases in risks for infectious and allergic diseases were also found: Adenotonsillectomy was associated with a 17% increased risk of infectious diseases (RR = 1.17) corresponding to an absolute risk increase of 2.14% because these diseases are relatively common in the population. Adenoidectomy alone was associated with a more than doubled relative risk of chronic obstructive pulmonary disorder (RR = 2.1) and nearly doubled the relative risk of conjunctivitis (RR = 1.75).
When all 28 respiratory, infectious/parasitic, skin, musculoskeletal, and eye/adnexa disease groups in the study were considered, the surgeries bestowed small but significant increases in relative risk for 78% of them. “The negative health consequences of these surgeries within the first 30 years of life thus appear to be consistent, affecting a range of tissues and organ systems,” they wrote.
The authors concluded by stating that increases in long-term absolute disease risks were considerably larger than changes in risk for the disorders these surgeries aimed to treat.