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Research Looks at How Tonsillectomy Impacts Throat Infections and Sleep Apnea in Children

Authors of a research review sponsored by the Agency for Healthcare Research and Quality appearing in the February 2017 Pediatrics examine the impact of tonsillectomies in children with a moderate number of throat infections and sleep apnea. For the publication, “Tonsillectomy vs. Watchful Waiting for Recurrent Throat Infection: A Systematic Review,” (published online Jan. 17) researchers conducted a systematic review examining illness rates and quality of life for children who have undergone tonsillectomies versus watchful waiting for throat infections.  While there is more robust evidence to support tonsillectomy in children meeting the high infection rate described in the Paradise Criteria, this review included studies that enrolled children with a more moderate number of infections. They found that throat infections and school absences declined in the first post-surgical year – as did the number of health care visits for sore throat and throat infections. In the first year post-surgical year, the tonsillectomy group had 1.74 episodes of sore throat or throat infection compared to 2.93 episodes for who did not undergo surgery. The benefits of surgery waned over time and information on long-term outcomes is limited. There was no marked difference for quality of life scores in the surgery versus non-surgery groups.  The authors conclude that individual decision-making is needed to consider the benefits of reducing illness outcomes, including missing school and work, with the risks associated with the surgery.  A companion review, “Tonsillectomy for Obstructive Sleep-Disordered Breathing: A Meta-Analysis,” examined whether children with obstructive sleep-disordered breathing showed improvement after tonsillectomy.  The same authors found that children who had surgery had better sleep outcomes than those who engaged in watchful waiting.


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