Tonsillectomy in children with asthma is associated with a significant improvement in their asthma symptoms. According to David E Karas, MD, a pediatric otolaryngologist at Yale University, "We're not saying you get a tonsillectomy if you have asthma. But it's clear that the surgery improves upper respiratory congestion and chronic sinusitis."He went on, "When the upper airway is not doing well, that eventually takes a toll on the lower airway, and when we treat the upper airway, the lower airway can improve."
The children in his study required significantly less medicine after their surgery. Their asthma severity symptom scores (a standardized means of evaluating asthma) decreased from 2.0 to 0.81, a significant change. The improvement was found in children with mild, moderate and severe asthma. Number of missed school days fell from 12.5 per year to six, and number of workdays missed by caregivers per year decreased from 13 to two.
Asthmatic children have more flare-ups in the fall and winter when infections are more common than other times of the year. This may be due to the relationship between upper air infection and lower airway dysfunction. Their symptoms improve with both oral corticosteroids and antibiotics.
"There's nothing that shrinks the tonsils like steroids - it's like you're giving a temporary medical tonsillectomy. And antibiotics treat the infective component by preventing those infected secretions that might be micro-aspirated (inhaled into the lungs) and start up a reactive airway process."
Family Practice News, 4/15/06
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