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Does Your Kid Really Need a Tonsillectomy?

Photograph by Twenty20

Although many think of getting their tonsils out as a routine part of childhood, and more than half a million kids under the age of 15 go under the knife annually to remove tonsils, it is still a risky procedure despite being one of the most common surgeries performed on children.

Now, the lasting benefits of tonsillectomies are being called into question in new research published in the journal Pediatrics.

A few new studies looked at whether tonsillectomy or adenotonsillectomy (that's having both your tonsils and adenoids out) were effective at warding off recurrent throat infections, and whether tonsillectomy was effective at reversing obstructive sleep-disordered breathing conditions such as sleep apnea. Both studies pit surgery versus "watchful waiting" and supportive care (aka basically doing nothing but trying to stay healthy).

In all studies, the kids who had a tonsillectomy had slightly less repeat infections within the first year after surgery. But researchers say there's not enough evidence of whether the surgery really helps avoid further infections in the future beyond a couple of years.

What they did find, however, was that about 8 percent of kids end up back in the hospital within a month after their tonsillectomy, due to problems such as bleeding, infection, pain, or vomiting and dehydration. And while that rate isn't abnormal, about one-third of those patients end up readmitted for those issues—which is alarming if you're a parent who's constantly visiting the pediatrician to treat a kiddo with chronic throat infections.

The studies found that the benefits of those surgeries even out over time. That is, after three years, kids who had the surgery end up with about the same number of throat infections as kids who did not have surgery.

So which kids should get their tonsils out? Doctors say if your child has sleep-disordered breathing problems and recurrent throat infections, they may be a good candidate. But being a "good candidate" doesn't mean getting your kid's tonsils out will be the best course of action. However, if your child suffers from chronic throat infections such as strep or tonsillitis, the short-term relief may just be worth going under the knife.

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