Published: Sat, June 09, 2018
Health Care | By Cedric Leonard

Tonsil removal in childhood may increase asthma risk

Adenoid surgery is also performed to improve breathing when the airways are blocked. However, tonsils and adenoids act as the first line of defense against bacteria and viruses from entering the lungs and throat.

He said the underlying reasons behind why the kids have their tonsils and adenoids removed in the first place could be responsible for the increased risk of other illnesses.

The research has found children who have their tonsils or adenoids removed are up to three times more likely to contract respiratory diseases when they get older. The study provides more evidence to support possible alternatives to surgery when possible.

University of Melbourne researcher Dr Sean Byars and Professor Jacobus Boomsma from the University of Copenhagen led the research, with Professor Stephen Stearns from Yale University.

For the study, the researchers examined Danish health records, following more than 60,000 children who had tonsils removed, adenoids removed or both ("adenotonsillectomy") before age 10.

"It's relatively uncommon to see a child who's had one nowadays without there being a good indication".

Because tonsils and adenoids are part of the immune system, researchers said removing them while children were still developing could make them more susceptible to infections and allergies.

The risk of upper respiratory diseases - asthma, influenza, pneumonia and chronic obstructive pulmonary disorder (COPD) - was nearly triple for children who had had a tonsillectomy, compared to those still with their tonsils.

COPD is the umbrella term for diseases such as chronic bronchitis and emphysema.

The absolute risk (which takes into account how common these diseases are in the community) was also substantially increased at 18.61 percent.

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"The association of tonsillectomy with respiratory disease later in life may therefore be considerable for those who have had the operation", Prof Boomsma said.

People who have their adenoids taken out are more than twice as likely to develop COPD and have a almost doubled risk of diseases of the sinuses, nose and throat and conjunctivitis. The absolute risk was also nearly doubled for upper respiratory diseases but corresponded to a small increase for COPD, as this is a rarer condition in the community generally.

They found the increased risk of illness meant there would only need to be five tonsillectomies or nine adenoidectomies for one additional patient to be diagnosed with a respiratory tract disease such as a throat or sinus infection.

The team also analysed conditions that these surgeries directly aimed to treat, and found mixed results.

For example, tonsillitis and sleep disorders were greatly reduced after tonsils and adenoids were removed. But others, such as sinusitis, increased up to age 30, Byars said.

All surgeries eliminate the risk of tonsillitis and chronic tonsillitis because the tonsils are removed.

Instead, the longer-term risks for abnormal breathing, sinusitis and otitis media were either significantly higher after surgery or not significantly different.

Experts have said the 30-year research, which involved almost two million children, indicates that while the modest benefits of the operation - preventing a recurring sore throat - mostly vanish by the age of 40, it boosts the lifetime risk of serious conditions.

Dr Byars said given the tonsils and adenoids played a key role in the development of the immune system, it was "not surprising" their removal might increase the risk of later respiratory and infectious diseases.

"In 1870 Charles Darwin famously said that the appendix was a useless vestige of evolution, predicting it was too small to contribute to digestion in any meaningful way".

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