TONSILS IN THE NEWS

New Zealand Listener, Volume 37, Issue 939, 9 August 1957, Page 24

TONSILS IN THE NEWS

This is the text of a talk on health broadcast recently from ZB, ZA, YA and YZ

stations of the NZBS by DR

H. B

TURBOTT

Veputy-Director-General of Heaith

HE doctor who removed the tonsils of Prince Charles must have been very sure of his ground, for opinions on the value of the operation keep changing with the passing years. Had anything gone wrong one can imagine the controversy that would have been touched off, One famous London _hospital, Great Ormond Street Hospital for Sick Children, recently checked up on the value of the removal of tonsils and adenoids. An ear, nose and throat surgeon there decided to study the results from 50 consecutive operations on doctors’ children, considering that doctors would probably give a more accurate technical assessment than nonmedical parents. He asked for true reports, even if they showed that the operation did not have all the good effects desired. In years’ gone by tonsils were removed if they were big, but not so nowadays unless there are indications they are causing trouble. Adenoids may still be taken away because of sizé alone, when they are big enough to block considerably the nasal passage, and that one between the nose and the middle ear. The general wish now is to leave these collections of lymphoid tissue which we dub tonsils and adenoids, if at all possible. Their work is to act as a filter, to hold back germs and viruses from nose and mouth, and to kill these if possible, so protecting the body from infections. If these tissues lose the battle, they are overwhelmed with infection themselves, enlarge in the struggle, and become pockets of sepsis. THey may recover | completely when the infection has run

its course in the body, or they may be. left enlarged, and particularly ‘in the case of the tonsils, be left with hidden, deep little pockets of septic infection, a chronic source of trouble thereafter. It is such tonsils, no matter what their size, that need removal. In the study mentioned, a check was made to see whether the trouble | which led to re-

moval was obviated by the operation. The commonest trouble had been inflamed throats, repeated sore ones, sometimes going on to marked tonsillitis and quinsy. Only three out of the 42 with this symptom remained subject to sore throats after the operation. Trouble in tonsils and adenoids is often the hidden cause of earache and deafness, particularly from adenoids. Again there was benefit; only three out of 35 with ear trouble beforehand were not improved. An accompaniment of diseased tonsils is often enlarged glands in the neck. Of the 33 children who had enlarged cervical glands, in only three was"there no marked improvement following the operation. Twenty out of 26 children who had suffered from repeated colds were reported to be greatly improved, and in only five was there -thought to be no change. The operation on the 50 children was followed in 35 by general benefit to health. To sum up: 40 doctors were satisfied with the result of the operation on their children, six thought it was partially successful, three thought there

was no benefit, and one was frankly disappointed Sulphonamide and antibiotic drugs are used widely nowadays in fighting inflamed tonsils, quinsy, middle ear infections, and such troubles which stem from overwhelmed tonsils and adenoids. These body defences may, however, be left so enlarged as to cause mechanical troubles in the airways, or so chronically infected as to be reservoirs of recurring upsets in nose, ear, or throat, or neck glands. A high proportion of cures and improvement results when removal is decided on following tonsillitis, sore throats, middle ear infections and deafness, enlarged neck glands, and repeated colds. The history of a child’s health is very important, therefore, in deciding the fate of doubtful tonsils and adenoids, and the doctor depends. on you for this story. He is guided by this story ‘more than by the size or state of the tonsils at one examination. How can you help the doctor determine whether tonsils and adenoids may be kept or must come out? By watching for and noting these things: frequent sore throats with raised temperatures; attack of tonsillitis or quinsy (abscesses round the tonsils); frequent earache, perhaps going on to ear abscess; imperfect speech or blocked breathing; attacks of sore glands under the jaw angles in the neck. With any of these, singly or in company, and re-

curring, you will build up a doubt about tonsils and adenoids. This doubt will be reinforced if there is a tendency to worrysome colds. These are the grounds on which removal decisions are made. As we want to keep them if we can, there must be very definite evidence that they are doing harm before children are subjected to operations for removal.