Tonsil removal has no major benefits over watchful waiting in children with throat infections or enlarged tonsils and adenoids

Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy: open, randomised controlled trial, BMJ Online First.

Surgical removal of the tonsils and adenoids (adenotonsillectomy) in children with mild symptoms of throat infections or enlarged tonsils and adenoids has no major benefits over watchful waiting, finds a new study published on bmj.com today.

Adenotonsillectomy is a common procedure in children in western countries, yet evidence of its benefits in children with milder symptoms is lacking.

Researchers in the Netherlands monitored 300 children aged 2-8 years with recurrent throat infections or enlarged tonsils and adenoids. Half were allocated to surgery and half to watchful waiting. All children were monitored over two years.

During the first six months, surgery marginally reduced the number of episodes of fever, throat infections, and upper respiratory tract infections. But from six to 24 months, there was no difference between the groups.

The authors conclude that adenotonsillectomy has no major clinical benefits over watchful waiting in children with mild symptoms of throat infections or enlarged tonsils and adenoids.