Tonsillectomy, or removal of the tonsils, is the most common major surgery performed on children in the U.S. In 1996, nearly 300,000 children under age 15 underwent some form of tonsillectomy to prevent serious or recurring infections.

This surgery has been around forever, and is proven effective for children with severe, recurrent throat infections. Yet insufficient evidence supports this procedure in children with only moderate infections.

In a study at the Children's Hospital of Pittsburgh, over 300 children ages 3-15 were utilized based on the determination that they suffered from throat infections to a greater degree than recommended for surgery under current guidelines, but to a lesser degree than children in previous studies on the effectiveness of tonsil removal. Children received either no surgery or one of two forms of tonsillectomy.

Although surgery groups showed lower rates of throat infection than nonsurgery groups over the three years after surgery, rates of moderate-to-severe infection were still considered "low" in nonsurgery groups. Also, despite a slightly lower infection rate, nearly 10% of the children who had surgery developed complications.

Under current guidelines, it appears that too many tonsillectomies are being authorized. The authors of this study in Pediatrics conclude that the relatively insignificant advantage currently gained from tonsillectomies in moderately affected children does not justify the risks, pain, and financial costs involved.

Reference:

Paradise JL, Bluestone CD, Colborn DK, et al. Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children. Pediatrics 2002:110(1), pp. 7-15.

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