© 2003 BMJ Publishing Group & Royal College of Paediatrics and Child Health
LEADING ARTICLE
Surgery
Tonsillectomy
The Radcliffe Infirmary, Oxford OX2 6HE, UK; mburton@cochrane-ent.org
In or out of fashion?
Keywords: tonsillectomy
| The first 150 words of the full text of this article appear below. |
Tonsillectomy was once fashionable. Regarded as a panacea for upper respiratory tract problems, many children in the late 1950s and 1960s underwent tonsillectomy. In 1967, 120 per 10 000 children (age 
14 years) had their tonsils removed. But over the years fashions change; by 1985 this was 51 per 10 000, up to 81 in 1990, and down again to 65 in 1998.1
As an issue, tonsillectomy is back in fashion for two important reasons—the increasing focus on "evidence based medicine", and the recent débcle about disposable surgical instruments and new variant Creutzfeldt-Jakob disease (vCJD).
In a Cochrane systematic review2 we found no good evidence for or against tonsillectomy. Evidence from two randomised controlled trials (RCTs) in children3,4 was inconclusive. There has been some scepticism about the review’s conclusion that a further RCT is required to address this issue. Surely, taking the tonsils out must prevent tonsillitis? It
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Ear, nose and throat/otolaryngology
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TB and other respiratory infections
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