19 June 2018

Study: Tonsil and adenoid removal associated with respiratory diseases, allergies and infections


Health data from more than one million Danish children serves as foundation for University of Copenhagen study reporting considerably higher risks for certain respiratory diseases, among other things, as a result of tonsil removal.

Tonsils and adenoids serve a role in the human immune system and contribute to white blood cell production. They also monitor what passes through the throat and appear to 'train' the immune system of children.

In a comprehensive study, evolutionary biologists from the University of Copenhagen’s Department of Biology, the University of Melbourne and Yale have demonstrated that people who had their tonsils and adenoids removed during childhood, were subject to an increased risk of developing respiratory diseases, allergies and infectious diseases later on in life.

The researchers analyzed health data from nearly 1.2 million Danish children born between 1979 and 1999, from the age of 10 and up to 30-years-old.

Of the 1.2 million children, more than 60,000 had their tonsils, adenoids, or both removed before the age of 9. The researchers discovered a significantly increased risk of being afflicted by diseases including asthma, pneumonia, chronic obstructive pulmonary disease and other respiratory infections, compared with the group whose tonsils were not removed.

"In particular, we found a significant link between having had tonsils or adenoids removed and upper respiratory tract disease later on in life," says Professor Jacobus Boomsma of the University of Copenhagen’s Department of Biology. 

Tonsils are not there by chance
Tonsils and adenoids serve a role in the human immune system and contribute to white blood cell production. They also monitor what passes through the throat and appear to 'train' the immune system of children.

"Our research always begins with evolutionary assumptions – in this case, that the immune organs surrounding our airways are not coincidental, but there due to some sort of useful biological adaptation. As such, it is reasonable to ask if removing them provokes any long-term consequences," states Boomsma

Furthermore, the study suggests an increased risk of pneumonia and asthma later in life as a result of tonsil and adenoid removal, as well as a far higher incidence of nose and eye allergies.

"The extensive dataset from Denmark provides us with unique opportunities to look at broader contexts, as we are able to consider a range of other health factors and socio-economic differences among families, which results in more accurate results," adds Boomsma.

Operations offer mixed long-term results
Researchers were careful to study whether tonsillectomies and adenoidectomies had any real impact on the ailments that they were intended to remedy. The results were mixed.

"According to our study, adenoid removal reduces the risk of sleep disorders and throat inflammation to a slight degree, but increases the risk of middle ear infections. Therefore, the long-term benefits remain unclear," explains Boomsma.

The article emphasizes that the potential long-term effects of tonsil and adenoid removal have not been documented until now, and that this study ought to catalyze renewed discussion in cases where non-surgical treatments are an option for young people suffering from breathing, sinusitis and otitis media problems.

Researchers point out that while there may be medical grounds for performing tonsillectomies and/or adenoidectomies, the study’s conclusions are clear and should be considered within the context of thorough individual assessments.

"We believe that our results are solid, not least because we have been able to clean our data by accounting for 18 other factors that might come into play. We would have liked to correct for smoking, but the health register lacked this information. Other Nordic countries have collected similar datasets for their populations for over roughly thirty years, so corresponding analyses would be of great interest," suggests Boomsma.