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11 cases were operated on for enlargement of tonsils alone,
without any symptoms. In 2 of these cases the child was said to
be brighter, in 7 cases no change was noticed by the parents, and
the last child was definitely worse as he had frequent colds after
the operation, whereas he had not suffered from colds previously.
This child was found on examination to have very wide anterior
nares and thus a larger air way than normal. Removal of lymphoid
tissue from the post nasal space would be expected to aggravate
the condition.
In 9 cases, tonsils and adenoids were removed for mouth
breathing and in only 2 of these cases was any improvement seen.
An interesting point in this connection is that the children in whom
improvement occurred were 12 and 7 years of age respectively
while the ages of the children in whom there was no improvement
ranged from 5 years down to 3 years. In the 2 older children
breathing exercises had been carried out after operation, and the
benefit was probably largely due to this.
3 cases were operated on for tonsillitis and discharging ears.
All were improved.
1 child had suffered from rheumatism and was better after
the operation.
4 children were operated on for deafness and 2 of these
were definitely better.
Other reasons given for operation were, nerves, stomach
trouble, and general irritability. None of the children in this group
showed any improvement.
The number of cases in this investigation was not large, but
the reasonable conclusion which one draws from a consideration of
the cases is that removal of tonsils and adenoids without definite
evidence that they are doing harm is obviously not worth the risk
and unpleasantness which the child has to suffer.
Comment on the cases quoted is almost unnecessary. In
many of the cases we have no proof that the tonsils and adenoids
were the cause of the child's ill health and in these cases no improvement
resulted.
Unfortunately, the operation has now come to be regarded
by parents as almost a normal proceeding in the life of a child so
that we frequently have difficulty in persuading parents that the
operation is unnecessary for some trifling ill.