Tonsillectomy Does Not Reduce Upper Respiratory Infections: A National Cohort Study

Area of Science:

• Otolaryngology
• Pediatric Health
• Epidemiology

Background:

• Upper respiratory infections (URIs) are common, particularly in children.
• Tonsillectomy is a surgical procedure to remove tonsils, often performed for recurrent URIs.
• The impact of tonsillectomy on long-term URI frequency requires further investigation.

Purpose of the Study:

• To compare the incidence of post-operative upper respiratory infection (URI) visits between patients who underwent tonsillectomy and a matched control group.
• To determine if tonsillectomy influences the long-term frequency of URI-related healthcare utilization.

Main Methods:

• A national cohort study utilized data from the Korean Health Insurance Review and Assessment Service.
• 5,831 tonsillectomy patients were matched 1:4 with 23,324 control participants based on age, sex, income, region, and pre-operative URI visits.
• Post-operative URI visits were tracked for 1 to 9 years, with equivalence testing used to assess differences.

Main Results:

• No statistically significant difference in the number of post-operative URI visits was observed between the tonsillectomy and control groups over 1 to 9 years.
• URI visits naturally decreased over time in both groups, from 5.5 visits/2 years pre-operatively to 1.4 visits/year at 9 years post-operatively.
• Subgroup analyses in children, adolescents, adults, and based on pre-operative URI frequency also showed no difference between the groups.

Conclusions:

• Tonsillectomy does not appear to decrease the number of post-operative visits for upper respiratory infections.
• Upper respiratory infection frequency naturally declines over time, irrespective of whether a tonsillectomy was performed.
• The findings suggest that tonsillectomy may not be an effective intervention for reducing long-term URI burden.