ENT Center of Austin - Doctor's Blog

Are More People Getting Their Tonsils Removed?

Just because you'd like to have a long-term diet of eating ice cream is no excuse for getting your tonsils removed. Trust us, there are better reasons.

Tonsil Girl

This type of procedure has been going on long before the soft desert was invented. As a matter of fact, people getting their tonsils snipped has been happening for about 3-thousand years. Only nowadays, your Austin Ear Nose and Throat Clinic doesn't use an iron chisel and a heavy stone to take-out the mostly useless piece of meat in our throats.

Nonetheless, some would seem to think that the operation is on the rise in the 21st century.

 

Maybe Yes, Maybe No

One would be hard-pressed not to admit that we're in the information age. We live in a world of numbers, categorization, data collection and basically keeping records of everything. So, there's one reason we may believe that cutting-out your tonsils are exploding. After all, a thousand years before the life of Christ, papyrus was in short supply. They kept terrible records back then.

However, a recent study published in the Journal of Pediatrics throws a light on the subject. Turns out it all depends on where they stand on the socioeconomic scale and where they live in the world.

Commenting on the survey, another authoritative publication that deals with issues of the throat gives this perspective. David Goodman, MD, MS, professor of pediatrics at The Dartmouth Institute for Health Policy and Clinical Practice at Geisel School of Medicine at Dartmouth in Hanover, N.H says, “Previous studies show that a substantial proportion of regional variation reflects differences in provider practice patterns not explained by patient needs or preferences. Seventy-five years after Glover published his seminal study of tonsillectomy in school aged-children in England, we still have insufficient information on the short- and long-term outcomes of the medical and surgical therapies.”

So Is It Up or Down?

Referring back to an earlier statement, it does distill down to our modern obsession with keeping records. Craig Derkay, MD, FACS, FAAP, professor and vice chairman of otolaryngology at Eastern Virginia Medical School and director of pediatric otolaryngology at Children’s Hospital of the King’s Daughters in Norfolk, VA agrees, “it may look like there are more being done, but we’re really counting them better. We’re capturing them all.”

How Do I Know When I Need the Operation?

It's all up to the doctor to make a recommendation, but most specialists say that kids will greatly benefit from a tonsillectomy is they are prone to strep throat. That malady, over repeated time, can lead to damage to other organs, The sooner the villain is removed, the less likely a patient is to come down with other downstream problems.

Other Analysis

This one comes to us from the online magazine called ENT Today. In it the author wrote, "The review of five studies—four undertaken in children (719 participants) and one in adults (70 participants)—indicated that this advantage applied to youngsters with the most severe disease. “One reason why the impact of surgery is so modest is that many untreated patients get better spontaneously,” the review’s authors stated. “There is a trade-off for the physician and patient who must weigh a number of different uncertainties: What proportion of the symptoms are attributable to my tonsils, and will it get better without any treatment? Similarly, the potential ‘benefit’ of surgery must be weighed against the risks of the procedure.”

Rest assured, when you visit us at the ENT Center of Austin, we've keep-up with the latest studies. Especially a new evidence-based guideline which came out in early 2011. The recommendations are pretty clear:

  • Watching to see how many episodes happened in the prior year.
  • Noting if fewer than five episodes per year in the prior two years have occurred.
  • And documenting whether fewer than three episodes per year in the previous three years have happened.

Anytime you or your children come-down with a sore throat, come see us. Like the rest of the folks in the info age, we'll keep records and make recommendations when the time is ripe. And we don't use chisels and stones.

Image Source: biologycs

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