Study of the Effects of 736 Tonsillectomies and of 741 Controls

Monroe, John D.; Volk, V. K.

doi:10.2105/ajph.20.5.495

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…For example, in the older studies by Kaiser and Monroe,[25][26][27] inclusion criteria and outcomes are ill defined, while in the more recent studies they are better defined. 18 29 30 Despite these shortcomings the results of the more recent and better controlled studies 18 28-30 are surprisingly similar to those of the randomised trials and therefore support evidence on the efficacy of (adeno)tonsillectomy from the trials.…”

Section: Discussionmentioning

confidence: 99%

Adenotonsillectomy for upper respiratory infections: evidence based?

Staaij

Akker²,

Heijden³

et al. 2005

Archives of Disease in Childhood

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Background: Despite high rates of (adeno)tonsillectomy for upper respiratory infections in western countries, the medical literature offers the physician little support in deciding which child might benefit from the operation. Methods: A literature search was performed to identify randomised trials and non-randomised controlled studies into the efficacy of tonsillectomy with or without adenoidectomy in children under 18 years. For the outcomes sore throat episodes, sore throat associated school absence, and upper respiratory infections, pooled estimates of the incidence rate ratios and rate differences with 95% confidence intervals were calculated, assuming a Poisson distribution. Results: Six randomised trials and seven non-randomised controlled studies on the efficacy of adenotonsillectomy in children were evaluated. For sore throat episodes data for 2483 person-years were available. The pooled risk difference was 21.2 episodes per person-year (95% CI 21.3 to 21.1). For sore throat associated school absence 1669 person-years were analysed. The pooled risk difference was 22.8 days per person-year (95% CI 23.9 to 21.6). For upper respiratory infections 1596 personyears were available. The pooled risk difference was 20.5 episodes per person-year (95% CI 20.7 to 20.3). Conclusions: All available randomised trials and non-randomised controlled studies into the efficacy of (adeno)tonsillectomy had important limitations. The frequency of sore throat episodes and upper respiratory infections reduces with time whether (adeno)tonsillectomy has been performed or not. (Adeno)tonsillectomy gives an additional, but small, reduction of sore throat episodes, days of sore throat associated school absence, and upper respiratory infections compared to watchful waiting

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Section: Discussionmentioning

confidence: 99%

Adenotonsillectomy for upper respiratory infections: evidence based?

Staaij

Akker²,

Heijden³

et al. 2005

Archives of Disease in Childhood

View full text Add to dashboard Cite

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Tonsils and Adenoids

Hansel¹

1931

Archives of Otolaryngology - Head and Neck Surgery

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In reviewing the literature for 1930 on the tonsils and the adenoids, I have selected only those papers which promote discussion and those which, according to my judgment, show the advances made in this particular field of otolaryngology during the past year. Interesting papers by Monroe and Volk, McLean and Kaiser were directed toward the study of large groups of children for the results of tonsillectomy. A great deal of interest has been exhibited in the consideration of the complications of tonsillectomy. A symposium on the subject of pulmonary abscess following tonsillectomy, which was given before the American Bronchoscopic Society, considered all phases of this subject in a comprehensive manner. Other complications of tonsillectomy, such as thrombophlebitis of the internal jugular vein, pyemia, deep cervical infection and parapharyngeal abscess, were presented by various authors in several interesting papers. In the treatment of the tonsils, renewed interest has been exhibited in the use of electrocoagulation and irradiation. Several new instruments have been designed and described. GENERAL CONSIDERATIONSMonroe and Volk analyzed the complaints of 736 children before and after operation, and compared the results with an analysis of the complaints of 741 children in a control group having similar symptoms on examination and reexamination one year later. The following conclusions are drawn : Tonsillectomy offers a child considerable relief from such common conditions as sore throat, head colds and breathing through the mouth. Tt reduces malnutrition and promotes the disappearance of enlarged cervical glands. Complaints have been relieved in 91 per cent of patients operated on. In order to obtain the maximum benefit, the child should be operated on in early childhood. Improvement followed operation in 40 per cent of children with subnormal mentality and showing retarded progress in school resulting from enlarged tonsils and adenoids. In the 736 cases analyzed, coexisting conditions were present in 120. The control group of cases did not Downloaded From: http://archotol.jamanetwork.com/ by a University of Iowa User on 06/15/2015

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Evaluation of the Results of Tonsillectomy and Adenoidotomy

Selkirk¹

1931

Arch Pediatr Adolesc Med

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The subject of tonsillectomy and adenoidotomy has great interest for the pediatrician. In common with others, we have been impressed with the unsatisfactory basis on which the indications for the operation rest.Personal opinions are of little worth in evaluating the results that are obtained. Any one with large clinical experience can recall patients whose improvement after tonsillectomy, and apparently because of it, constitutes an argument for its value; on the other hand, other patients can be brought to mind in whom the failure to improve after operation might be equally valid proof of the failure of tonsillectomy to accomplish the expected or the desired results. The pediatrician may well be concerned with the problem, for the rhinolaryngologist, whose opinion is often relied on when tonsils and adenoids are removed, has little opportunity to study the effects of his work.Doubts as to the benefits from tonsillectomy in many cases have led to the attempt to evaluate the results of tonsillectomy, in order that the indi¬ cations for its performance may be better established. We have from time to time participated in such discussions.1 The latest attempt to follow up carefully a group of children on whom tonsillectomy and adenoidotomy were performed has added to our doubts of the possi¬ bility of analyzing satisfactorily our personal studies, and has inci¬ dentally increased our skepticism of the conclusions drawn in many of the studies made by others. While we shall present certain facts con¬ nected with our present study, this paper is concerned chiefly with a statement of the difficulties surrounding the whole problem. The anatomy, pathology and function of the tonsils are matters which will be mentioned only casually because we are not primarily concerned

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Study of the Effects of 736 Tonsillectomies and of 741 Controls

Cited by 3 publications

References 8 publications

Adenotonsillectomy for upper respiratory infections: evidence based?

Adenotonsillectomy for upper respiratory infections: evidence based?

Tonsils and Adenoids

Evaluation of the Results of Tonsillectomy and Adenoidotomy

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