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Background: Despite high rates of (adeno)tonsillectomy for upper respiratory i nfections in western countries, the medical literature offers the physician litt le support in deciding which child might benefit from the operation. Methods: A literature search was performed to identify randomised trials and non-randomise d controlled studies into the efficacy of tonsillectomy with or without adenoide ctomy in children under 18 years. For the outcomes sore throat episodes, sore th roat associated school absence, and upper respiratory infections, pooled estimat es of the incidence rate ratios and rate differences with 95%confidence interva ls were calculated, assuming a Poisson distribution. Results: Six randomised tri als and seven non-randomised controlled studies on the efficacy of adenotonsill ectomy in children were evaluated. For sore throat episodes data for 2483 person -years were available. The pooled risk difference was-1.2 episodes per person -year (95%CI-1.3 to-1.1). For sore throat associated school absence 1669 p erson-years were analysed. The pooled risk difference was-2.8 days per person -year (95%CI-3.9 to-1.6). For upper respiratory infections 1596 person-ye ars were available. The pooled risk difference was-0.5 episodes per person-ye ar (95%CI-0.7 to-0.3). Conclusions: All available randomised trials and non -randomised controlled studies into the efficacy of (adeno)-tonsillectomy had important limitations. The frequency of sore throat episodes and upper respirato ry infections reduces with time whether (adeno)tonsillectomy has been performed or not. (Adeno)tonsillectomy gives an additional, but small, reduction of sore t hroat episodes, days of sore throat associated school absence, and upper respira tory infections compared to watchful waiting.
Background: Despite high rates of (adeno) tonsillectomy for upper respiratory i nfections in western countries, the medical literature offers the physician litt le support in deciding which child might benefit from the operation. Methods: A literature search was performed to identify randomized trials and non-randomized d controlled studies into the efficacy of tonsillectomy with or without adenoide ctomy in children under 18 years. For the outcomes of sore throat episodes, sore th roat associated school absence, and upper respiratory infections, pooled estimat es of the incidence rate ratios and rate differences with 95% confidence interva ls were calculated, assuming a Poisson distribution. Results: Six randomized tri als and seven non-randomized controlled studies on the efficacy of adenotonsill ectomy in children were evaluated. For sore throat episodes data for 2483 person-years The pooled risk difference was-1.2 episodes per person -year (95% CI-1.3 to-1.1). For sore th The pooled risk difference was-2.8 days per person -year (95% CI-3.9 to-1.6). For upper respiratory infections 1596 person-ye ars were available. The pooled risk Differences was-0.5 episodes per person-year (95% CI-0.7 to-0.3). Conclusions: All available randomized trials and non -randomized controlled studies into the efficacy of (adeno) -tonsillectomy had important limitations. The frequency of sore (Adeno) tonsillectomy gives an additional, but small, reduction of sore t hroat episodes, days of sore throat associated school absence, and upper respira tory infections compared to watchful waiting