A Systematic Review of the Literature on Evaluative Studies of Tonsillectomy and Adenoidectomy

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Abstract
Studies evaluating the results of T [tonsillectomy] and A [adenoidectomy] in the English language literature for the past 50 yr were evaluated according to the following parameters: study design, sampling, completeness of description of illness and therapy and precision of follup-up. Those studies which were most objective were awarded the highest points in each parameter. The maximum of points which a randomized, prospective, well-documented study could obtain was 34 points. All studies scored 18 points or less out of a possible 34 points. The average score of studies for T and A was similar to that of studies against, demonstrating that current data did not tell whether the procedure was beneficial or not. Aside from the high cost and lack of clearcut evidence of therapeutic efficacy, there was morbidity and mortality associated with T and A. In view of the cost, financial and human, as well as the lack of evidence clearly supporting the continued performance of this procedure, a prospective, properly randomized controlled study should be undertaken and the methodologic pitfalls annotated in this review should be guarded against.

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