Tuesday, July 10, 2018

Tonsillectomy May Worsen Long-term Health Outcomes

People who have their tonsils or adenoids removed before age 9 years are at higher risk for respiratory, infectious, and allergic diseases up to the age of 30 years, a population-based study of almost 1.2 million patients suggests.  
"We found that tonsillectomy was associated with a nearly tripled risk of upper respiratory tract diseases, and that adenoidectomy was associated with doubled risk of [chronic obstructive pulmonary disease] and upper respiratory tract diseases and nearly doubled risk of conjunctivitis," Sean Byars, PhD, from the University of Melbourne in Victoria, Australia.  
"Physicians often remove adenoids and tonsils to treat recurrent tonsillitis or middle ear infections".  "Understanding the longer-term impact of these surgeries is critical because the adenoids and tonsils are parts of the immune system, have known roles in pathogen detection and defense, and are usually removed at ages when the development of the immune system is sensitive."
Byars and colleagues say the findings should prompt renewed efforts to identify nonsurgical alternatives for treatment.

The study included 1,189,061 individuals for health outcomes through age 30 years. Some 17,460 participants had had their adenoids removed, 11,830 had had their tonsils removed and 31,377 underwent an adenotonsillectomy. The remaining participants in the sample served as controls.  

They found that tonsillectomy was associated with nearly a threefold relative risk (RR) of diseases of the upper respiratory tract, compared with children who had not had their tonsils removed.

Adenoidectomy, in turn, was associated with a greater than twofold risk for chronic obstructive pulmonary disease and a nearly twofold increase for respiratory tract diseases.

Furthermore, when investigators analyzed all 28 disease groups, "there were small but significant increases for 78% of them," the investigators state. For example, the RR for otitis media also increased 2- to 5-fold, whereas the risk for sinusitis after adenotonsillectomy increased by 68%.

However, surgical removal of the tonsils and the adenoids was not unilaterally associated with increases in worse health outcomes. Adenoidectomy, for example, reduced the relative risk for sleep disorders by 70%.  The two primary indications for tonsillectomy (with or without adenoidectomy) are obstructive sleep apnea syndrome (OSAS) and recurrent throat infection.

Surgery for recurrent throat infection is always elective, rarely leading to any serious consequence if deferred, and children may improve on their own, he added. As such, this study might prompt families considering tonsillectomy for recurrent throat infection to hold off on the surgery. If the indication for surgery was significant OSAS then surgery risks would not outweigh the benefits.

Chiropractic can help with ear/ throat infections by removing blockages (Eustachian tube) and boosting the immune system. Always better to try non-invasive chiropractic treatment before surgery or round after round of antibiotics.  If your child or someone you know suffers from these issues, tell them about chiropractic treatment.

Dr. Stephen Kelly is a Chiropractor at Family First Chiropractic and Wellness, located In Red Deer, AB
 www.family1stchiro.ca   Call 403-347-3261 to book an appointment.

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