Tonsillectomy Not Entirely a Good Idea for Both Children and Parents

Tonsillectomies are one of the most frequently performed surgeries for children suffering from repeated throat infections and related fevers.

According to a new study conducted by researchers at the University Medical Centre Utrecht in the Netherlands, children avoiding surgery had fewer annual visits to doctors and lower resulting medical costs due to fevers and throat infections.

The study was based on following a group of 151 children scheduled for tonsillectomy within six weeks and another 149 children who were assigned to be carefully supervised, meaning close monitoring and additional interventions if necessary. The researchers asked parents to track their children’s respiratory track symptoms, measure their temperatures daily and record any costs related to their care.

Dr. Erik Buskens, an epidemiologist and colleagues at the University Medical Centre Utrecht in the Netherlands says the surgery led to a considerable “increase in costs without realizing relevant clinical benefit.”

The study conducted between 2002 and 2003 excluded children with frequent throat infections or those who had their tonsils removed because of sleep apnoea.

The costs among the group, which did not have surgery, raised about 551 euros per year, with 46 percent less compared to 803 euros for children who had their tonsils removed.

Another discovery of the study was that children who avoided surgery and followed a medical treatment also had fewer fevers, throat infections and respiratory illnesses.

The researchers did not consider costs borne by parents in the form of missed days from work or other expenses related to their children’ s illnesses.

The number of tonsillectomies performed varies from a country to another. In 1998, 115 per 10,000 children had the surgery in the Netherlands, 65 per 10,000 in the UK and 50 per 10,000 in the U.S.

Surgery seems to be cheaper in the Netherlands than in many other countries, this explaining the higher number of children having it.

"Compared with other Western countries, our cost estimates may be low. In other settings, the cost-effectiveness would be further offset by more costly procedures," the researchers wrote.

The study is published in the Archives of Otolaryngology – Head and Neck Surgery.