Novel evidence depicting adverse long-term outcomes linked to tonsillectomy: a spotlight on overtreatment

Tonsillectomies (TEs) are the first line of treatment when patients present with recurrent tonsillitis, peritonsillar abscesses or obstructive sleep apnea. Though TEs have modest efficacy, they remain a common pediatric surgery in Canada. TEs are now viewed as a prophylactic measure used to prevent tonsil-related diseases. Simultaneously, there is a lack of evidence-based decision-making when recommending TEs, leading to overtreatment. Novel findings indicate that pediatric TE patients have an increased risk of complications and poor long-term outcomes including respiratory, infectious, and allergic disorders. A need for alternatives to TEs is evident; less invasive interventions with fewer perioperative complications and lifelong morbidities warrant further research. To prevent unnecessary adverse outcomes, healthcare providers should opt for more selective and evidence-based TE recommendations. Meanwhile, it is also imperative that physicians clearly communicate the potential quality of life implications associated with TEs. Healthcare and social mores surrounding TEs need to change towards a more evidence-based practice that focuses on improving patients’ quality of life. This commentary examines the current role of TEs, their long-term outcomes, and the implications of overtreatment.