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Sub-group A (935 Cases).
Only tonsils defective.
Observation Cases.—33 per cent, were recommended operation
subsequently. Of those under observation throughout, 50 per cent,
improved, 49 per cent, made no improvement, and 1 per cent,
became slightly worse.
Operation Cases.—The results of operation were very good,
over 98 per cent, having improved. Of those not operated on after
the initial recommendation, 56 per cent, improved; whereas of those
recommended operation as the result of subsequent observation,
only 28.3 per cent, improved. There were three cases who gained
no benefit from the operation. One developed chronic catarrh
with nasal obstruction; one had enlarged sub-maxillary and cervical
glands after the operation; and one developed middle ear disease,
the discharge continuing two years, but eventually clearing up.
Of the operations recommended, 44 per cent, were performed.
Though the results of non-operation are not quite so good as
in the same section of Group I, they are sufficiently impressive to
suggest that observation be continued for a year before operation
is advised.
Sub-group B (269 Cases).
Tonsils defective and tonsillar glands enlarged.
Observation Cases.—In this section only a small proportion
(13.4) were not recommended operation; and of these, 22 per cent,
were advised this treatment subsequently. Of those kept under
observation throughout, 71 per cent, improved and 29 per cent,
remained stationary.
Operation Cases.—Over 98 per cent, of the children operated
on improved. Of those not operated on after the initial recommendation,
52 per cent, improved; whereas of those not operated on as
the result of subsequent examination, only 37.5 per cent, improved.
The results of non-operation are not quite so good as in the
previous sub-groups with the exception of Group I (Sub-group D).
Operation should not be recommended immediately; and probably
a period of observation of from six months to one year is advisable.