Adults with recurrent sore throats may benefit from having a tonsillectomy in the short term, but the overall longer term benefit is still unclear, and any benefits have to be balanced against the side effects of the operation, according to this week's BMJ.
A small study of adults from Finland, published on bmj.com last month, showed that tonsillectomy significantly reduced the likelihood of further infection after 90 days, compared with watchful waiting.
But despite these promising results, an editorial in this week's journal warns that, until we have more evidence about the longer term benefits of surgery, it is difficult for doctors to provide firm advice to patients.
The main problem with the trial is that the follow-up period was relatively short, and people in the watchful waiting group reported improvement during the trial period, says Paul Little, Professor of Primary Care Research at the University of Southampton. This begs the question of whether the benefit of immediate tonsillectomy would be reduced if the follow-up was longer.
Other factors are the small size of the trial and insufficient data on the severity of infections.
Any benefits of the operation must be balanced against potential disadvantages, he writes. The major disadvantage documented in the trial is the 13 days of sore throat after tonsillectomy, which can be severe in many patients. Other disadvantages include the risks associated with an anaesthetic, earache, dehydration, and dental injures, and a risk of life threatening complications, such as major haemorrhage or sepsis.