Tonsilectomy & Adenoidectomy Risks Respiratory Disease Later

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Joined: 26 Feb 2013 09:59
Full Name: Kannivelu Badrinath
Name of Your College/Medical School: Madras Medical College, Madras, India

Tonsilectomy & Adenoidectomy Risks Respiratory Disease Later

Post by Badri »

Over the last few years there has been a significant decrease in the number of tonsillectomies and adenoidectomies performed. They have now confirmed that having your tonsils out as a child makes you three times as likely to suffer from common colds and other respiratory infections. It may also leave you more vulnerable to a host of other infectious diseases.

The common childhood removal of the tonsils or adenoids in the throat also increased the chances of allergic conditions and skin and eye diseases as well, Australian researchers found. This is likely to be because the tissues play an important role in the early immune system, detecting and blocking the invasion of bacteria and viruses into the lungs and throat.

Tonsils are often removed if they’re obstructing easy breathing, or where they are causing repeated bouts of tonsillitis and middle-ear infections. But the authors of this latest study say alternatives to surgery should be considered because of the increased risk of all types of infection.

“Risks were significant for many diseases and large for some,” after surgery, the authors write in the Journal of the American Medical Association, Otolaryngoloygy.

The study used health records from 1.2 million Danish children between 1979 and 1999, of which 60,400 had a tonsillectomy, adenoidectomy, or combined surgery. It looked at these same children in their 30s and found patients who had a childhood tonsillectomy tripled their risks of infections of the upper airways like colds, rhinitis and bronchitis, compared to people who kept their tonsils. The risk of asthma and pneumonia were also increased by roughly 50 per cent in people who had the surgery.

Removal of the adenoids doubled the risk of chronic obstructive pulmonary disease, which includes emphysema and asthma.

However these conditions are much rarer than respiratory tract infections overall – 0.25 per cent of the general population in their 30s have some form of COPD – so the impact is less pronounced.

They also found heightened susceptibility to 28 different types of disease, including parasitic infections, skin diseases and eye complaints – 78 per cent of these were experienced more commonly in people who had these surgeries.

These are unrelated to the airways and suggest there is some knock-on impact on the immune system from the loss of your tonsils or from the repeated minor infections this brings – this may become even more pronounced as the population ages.

"Our results 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,” said lead author Dr Shaun Bayers, from the University of Melbourne.

Tim Mitchell, a consultant otolaryngologist and council member of the Royal College of Surgeons, said the findings were interesting and "certainly warrant further investigation".
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Joined: 21 Jul 2013 12:13
Full Name: U A Mohammed
Name of Your College/Medical School: Madras Medical College

Re: Tonsilectomy & Adenoidectomy Risks Respiratory Disease L

Post by uamohammed »

Hi Badri
A timely reminder. It is a recognised fact that apart from tonsils and adenoids, appendix also plays a role in protecting our long gastrointestinal tract from invasion of bacteria and repeated gastrointestinal infection and as you have rightly pointed out the respiratory tract. I remember having read an article in BMJ some years ago which stated that a survey conducted by a team found most of the school going children had their tonsils removed except the children of ENT surgeons.

UA Mohammed
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