Byars SG, et al. - Authors evaluated the long-term disease risks related to adenoidectomy, tonsillectomy, and adenotonsillectomy in childhood. In this study of almost 1.2 million children, of whom 17,460 had adenoidectomy, 11,830 tonsillectomy, and 31,377 adenotonsillectomy, findings suggested an association of surgeries with increased long-term risks of respiratory, infectious, and allergic diseases. While making decisions to perform tonsillectomy or adenoidectomy, consideration of long-term risks was important.

Methods

• Experts conducted a population-based cohort study of up to 1,189,061 children born in Denmark between 1979 and 1999 and evaluated in linked national registers up to 2009, covering at least the first 10 and up to 30 years of their life.
• They selected the participants in the case and control groups such that their health did not differ significantly prior to surgery.
• They classified the participants as exposed if adenoids or tonsils were removed within the first 9 years of life.
• They examined the incidence of disease (defined by International Classification of Diseases, Eighth Revision [ICD-8] and Tenth Revision [ICD-10] diagnoses) up to age 30 years using stratified Cox proportional hazard regressions that adjusted for 18 covariates, including parental disease history, pregnancy complications, birth weight, Apgar score, sex, socioeconomic markers, and region of Denmark born.

Results

• As per data, they included a total of up to 1,189,061 children in this study (48% female); 17,460 underwent adenoidectomy, 11,830 tonsillectomy, and 31,377 adenotonsillectomy; 1,157,684 were in the control group.
• Results demonstrated that an association of adenoidectomy and tonsillectomy with a 2- to 3-fold increase in diseases of the upper respiratory tract (relative risk [RR], 1.99; 95% CI, 1.51-2.63 and RR, 2.72; 95% CI, 1.54-4.80; respectively).
• Researchers noted that in risks for infectious and allergic diseases, smaller increases were also found: adenotonsillectomy was associated with a 17% increased risk of infectious diseases (RR, 1.17; 95% CI, 1.10-1.25) corresponding to an absolute risk increase of 2.14% because these diseases are relatively common (12%) in the population.
• On the contrary, no significant difference was seen in the long-term risks for conditions that these surgeries aim to treat and were sometimes lower or higher.