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Had your tonsils out? Well, there was no need to!

Tens of thousands of people across Wales who have had their tonsils removed may not have needed the surgery.

According to new research by scientists in the Netherlands, tonsillectomies in children with throat infections have little benefit.

And the research, published today by the British Medical Journal , says removal of the adenoids, is also an operation with little benefit.

Tonsils removal is a common procedure throughout Europe though little has been done to look at what good it does.

Researchers at Wilhelmina Children's Hospital in Utrecht looked at 300 children aged two to eight years old with recurrent throat infection or enlarged tonsils and adenoids.

Half were allocated to surgery and the other half to 'watchful waiting'.

All children were monitored over a two-year period.

During the first six months, surgery marginally reduced the number of episodes of fever, throat infections and upper respiratory tract infections.

But from six to 24 months there was no difference between the groups.

The researchers concluded that adenotonillectomies for mild throat infections and enlarged tonsils or adenoids have no major clinical benefits.

Yesterday, Plaid Cymru AM Dr Dai Lloyd, a GP from Swansea, said, 'This really confirms what doctors have believed over the past 10 years or so.

'At one time it was common practice to whip out the tonsils and was done almost as a matter of routine,' Dr Lloyd said.

'When I was a child tonsils were taken out basically for no good reason.

'But doctors now are far more likely to watch and wait to see what happens and generally the symptoms of infection do not get much worse or recur too often.

'Tonsils do have a role. They are gatekeepers at the back of the throat.

'If there is a painful infection in the tonsils it could have been worse because the infection could have gone to the lungs. Doctors now think there are benefits to holding on to the tonsils.

'However in some cases where adenoids are enlarged or severely infected there is a case for taking these out.'

Dr Lloyd added, 'They are based at the back of the throat above the tonsils and blockages caused by inflamed or infected adenoids can lead to breathing problems or in some cases deafness.'

In January 2001, tonsillectomies were suspended in Wales because of concerns that surgical instruments could cause a spread of the human form of mad cow disease.

New 'throwaway' surgical instruments were developed so a backlog of tonsillectomy operations could be cleared up.

In 2001 in the UK, there were 12,500 people waiting for tonsillectomy operations.

Earlier this year the National Institute for Clinical Excellence urged doctors to reconsider the technique they use for removing tonsils amid concerns about patients bleeding and needing more surgery.

Their review of different procedures showed that operations that involved diathermy - where heat is used to remove tonsils and seal up the surrounding area - were much more likely to result in the patients bleeding after surgery.

This meant they were more likely to require re-admission and a return to the operating theatre than patients who were operated on using the 'cold steel' technique - not using heat.

Build up immunity

The tonsils are a pair of almond-shaped organs at the back of the mouth on both sides of the throat.

The adenoids are similar but are located in the upper portion of the throat behind the nose where they can't be seen.

They help to protect against germs entering the body through the mouth in early childhood by producing antibodies. They attack bacteria and viruses and help build up the body's immune system.

The problem is that in the process of protecting the body the tonsils and adenoids can become infected themselves.

As children grow and develop the tonsils and adenoids shrink and are probably no longer important in protecting against disease-causing germs.

Tonsils can become so enlarged they can affect a child's voice.

And abscesses on the tonsils, known as quinsy, can also be serious.
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Copyright 2004 Gale, Cengage Learning. All rights reserved.

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Publication:Western Mail (Cardiff, Wales)
Date:Sep 10, 2004
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