Tonsillectomies increasingly performed to treat snoring and sleep disorders

A new Mayo Clinic study indicates tonsillectomies are increasingly being performed to treat airway obstructions evidenced by snoring and sleep disorders as opposed to tonsil infections.

The study, led by a Mayo Clinic Medical School student, will be presented Sept. 18 at the American Academy of Otolaryngology -- Head and Neck Surgery in Washington, D.C.

“This research shows that obstructive airway problems causing sleep-disordered breathing are now the primary reason children and young adults are having their tonsils and adenoids removed,” says Britt Erickson, the Mayo Clinic medical student leading the team of researchers on this study. “This shift demonstrates that there is an increase in recognition of obstructive airway problems in children and young adults. This could mean that either the problem of sleep disorders is increasing, or that this problem has been here all along and only now is recognized.”

The study uses data from the Rochester Epidemiology Project of Olmsted County, Minn. to review tonsillectomy and adenotonsillectomy patients over the last 35 years. Researchers examined medical records of 8,106 patients ages 0 to 29 from 1970 to 2005. The team discovered that surgical removal of tonsils and adenoids occurred more than twice as often in 2000 to 2005 compared to 1970 to 1975. In 1970, nine out of 10 operations were done because of infection, and only one in 10 surgeries was for treatment of upper airway obstruction. In 2005, only about three in 10 surgeries were done exclusively for infection.

The research also shows that there is a difference between occurrence of tonsillectomies and adenotonsillectomies in boys and girls. Overall, girls were more likely to have their tonsils and/or adenoids removed, and girls between the ages of 18-22 were almost three times more likely than boys at this age to have chronic infections leading to tonsillectomy.

The findings suggest that parents and physicians have a better understanding of sleep-disordered breathing in children and are opting for surgery as their treatment of choice.

“The magnitude and quality of this study and its findings, are a reflection of the high caliber of our medical students and the research questions they are posing,” says Laura Orvidas, M.D., otolaryngologist and senior author of the study.

Researchers used the Rochester Epidemiology Project to identify children for the study, which was limited to children who resided in Olmsted County, Minn., between Jan. 1, 1970, and Dec. 31, 2005. The Rochester Epidemiology Project has developed an index of medical records of virtually all health care providers in Olmsted County. Olmsted County is served by a largely unified medical care system, including Mayo Clinic, which has accumulated comprehensive clinical records since the early 1900s.

Other Mayo Clinic researchers included Dirk Larson, Jennifer St. Sauver, Ph.D.; Ryan Meverden and Melissa Westergren.

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