The Benefits and Risks of Removing Children’s Tonsils and Adenoids

Removing children’s tonsils and adenoids has been a common practice for decades. These procedures are typically performed to alleviate breathing difficulties and recurring infections. However, some research has shed light on potential risks associated with these surgeries. What actually are the functions of tonsils and adenoids, though? Let’s look at the study that highlights the increased risk of diseases following their removal and discuss the benefits and risks associated with these procedures.

Understanding Tonsils and Adenoids

Tonsils and adenoids are part of the body’s immune system. Tonsils are two small masses of tissue located at the back of the throat, while adenoids are found at the roof of the mouth, close to the nasal cavity. Both structures play an important role in detecting and preventing the invasion of bacteria and viruses. They act as the body’s first line of defense against infection by trapping pathogens and initiating an immune response. (1)

So, if they’re so important, why remove them? Tonsils and adenoids can become infected or inflamed, leading to a condition called tonsillitis. A viral infection usually causes this condition, but bacteria can also cause it. In some cases, tonsillitis may be chronic (long-lasting) and require treatment with antibiotics. However, if the infection doesn’t respond to medication or if it recurs frequently, your doctor may recommend that you have your tonsils removed. 

The same is true for adenoids, which are located behind the nose and above the roof of the mouth. They help protect against infection by trapping bacteria and viruses that enter through the nose or mouth. If they become infected or inflamed, they can cause symptoms such as a sore throat, difficulty swallowing, snoring, or sleep apnea (a condition in which breathing stops and starts during sleep). If your child has frequent infections or other problems with the tonsils or adenoids, your doctor may recommend that they be removed. This is called a tonsillectomy (tahn-suh-LEK-tuh-mee) or adenoidectomy (ad-uh-NOY-dek-tuh-mee).

The Study and Its Findings

A 2018 study conducted by Australian researchers and published in the Journal of the American Medical Association, Otolaryngology, examined the health records of 1.2 million Danish children between 1979 and 1999. The study found that children who had their tonsils or adenoids removed were at a heightened risk of developing various diseases later in life. The increased susceptibility included 28 different types of diseases, such as parasitic infections, skin ailments, and eye conditions. (2)

They also found that these children were more likely to be hospitalized for respiratory conditions and more likely to develop asthma. In fact, the study found that children who had their tonsils or adenoids removed were more likely to be hospitalized for a variety of reasons. The researchers concluded that the removal of these organs may have long-term health consequences, including an increased risk of developing certain diseases later in life.

The Risks of Removing Tonsils and Adenoids

The risk factors identified in the study are a cause for concern. One significant finding was that the removal of tonsils tripled the likelihood of developing respiratory infections, including common colds, rhinitis, and bronchitis. Additionally, the risk of asthma and pneumonia increased by approximately 50%. These findings suggest that removing tonsils and adenoids may have implications for respiratory health and the overall immune system. Other risks include an increased risk of developing:

• Sleep apnea is a condition in which breathing stops and starts during sleep. This can lead to daytime sleepiness and other problems.
• Ear infections can cause hearing loss if left untreated.
• Sinusitis is an infection or inflammation of the sinuses that can cause facial pain, pressure, and congestion.
• Asthma is a chronic lung disease that causes wheezing, coughing, and shortness of breath. 
• Pneumonia is a lung infection that can be life-threatening if not treated promptly. 

A recent study has also identified a potential increase in the risk of developing cancer in the decades following the surgery. The researchers found a “modestly increased risk” of developing cancer that was seemingly independent of genetic or non-genetic factors. More research is needed in this area. (3)

The Benefits of Removing Tonsils and Adenoids

Before considering the potential risks, it is important to acknowledge the benefits that can arise from the removal of tonsils and adenoids. Evidence suggests that these procedures can effectively alleviate breathing difficulties caused by obstructed airways. When enlarged tonsils or adenoids obstruct normal airflow, it can result in sleep-disordered breathing and associated issues such as snoring and sleep apnea. Removing these structures can improve airflow and alleviate conditions that negatively impact sleep quality and overall well-being.

Additionally, removing tonsils and adenoids may reduce the frequency and severity of recurring infections. Chronic tonsillitis and middle-ear infections can cause significant discomfort and disrupt a child’s quality of life. By removing the source of infection, children may experience a decrease in the frequency of such infections, leading to improved overall health.

Balancing the Benefits and Risks

While there are clear benefits associated with the removal of tonsils and adenoids, the findings of the aforementioned study cannot be ignored. It is important for healthcare professionals and parents to carefully consider the potential long-term implications before opting for surgical intervention. Alternatives to surgery should be explored whenever possible, as the risks identified in the study were significant for various diseases and substantial for some. (4)

The Bottom Line

The decision to remove a child’s tonsils and adenoids should be carefully weighed, considering the individual’s unique circumstances and medical history. While these procedures can provide relief from breathing difficulties and reduce the frequency of infections, recent research suggests an increased risk of developing a range of diseases later in life. Healthcare professionals should engage in informed discussions with parents, providing a comprehensive understanding of the benefits and risks, thus empowering them to make well-informed decisions regarding their child’s health.

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