Walk into a room full of middle-aged adults, and you're likely to find several who have had their tonsils removed. Today, thanks to antibiotics and other treatments, tonsillectomies are much less common, though thousands of American children still have the surgeries each year. But, a new study from researchers in the Netherlands suggests that the procedure may not be helpful at all, especially for children who have only mild throat infections.

What the researchers wanted to know: Is tonsillectomy surgery better for children's health than carefully monitoring the infection and letting it run its course, taking action only if necessary?

What they did: Three hundred children with a history of mild (but not severe) throat infections participated in the study; half had a tonsillectomy and half did not have surgery right away, though some of those later went under the knife because of persisting infections. (The children who underwent surgery later were included in the nonsurgery group.Caveat below.) The researchers followed the children for two years and recorded the number of throat infections, missed days of school, fevers, daily temperature, and general health.

What they found: While there were mild improvements for children who had surgery at the outset, the differences were not big enough to justify surgery for children with mild throat infections. Compared with the group that did not have surgery right away, children who had a tonsillectomy had slightly fewer throat infections, days of missed school, sore throats, and upper respiratory infections, but those differences were small according to the researchers. In addition, 6 percent of all of the children who had surgery had complications so that, for minor infections, the risks may not outweigh the benefits. Children who had between three and six throat infections per year benefited more from surgery than children who had fewer than that.

What it means to you: Even though having your tonsils taken out is no longer a rite of passage as it used to be, the procedure is still done for thousands of children each year. This study shows that carefully monitoring the infections waiting to see if symptoms become severe may be a better idea than recommending surgery right away. For many children, infections will not get worse and the risks of complications from surgery will outweigh the benefits of slightly better health. For them, antibiotic treatments or just monitoring the infection may be just as beneficial, and not nearly as painful.

Caveats: About a third of the children not assigned to the surgery group had their tonsils surgically removed during the follow-up period because their infections would not go away. However, they were analyzed as part of the group that did not get surgery (because it was not immediate after the beginning of the trial). So, the data may have been skewed to show less of a difference between the two groups than was actually there.

Find out more: A good explanation of the function of tonsils and adenoids can be found on the website of the American Academy of Otolaryngology (Head and Neck Surgery).

Treatments for tonsillitis and a description of the surgery can be found at KidsHealth.org.

Read the article: Van Staaij, B.K. et al. "Effectiveness of Andenotonsillectomy in Children with Mild Symptoms of Throat Infections or Adenotonsillar Hypertrophy: Open, Randomised Controlled Trial." British Medical Journal. Sept. 18, 2004, Vol. 329, No. 7467, pp. 651-653.

Full Textonline: http://bmj.bmjjournals.com