Tonsils and Adenoids

Abstract

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