Childhood adenoidectomy or tonsillectomy doubles to triples the risk of upper respiratory disease later in life (Byars 2018, 1.19 million Danish children).
Original statement
في دراسة بيارز ومعاونيه على 1.19 مليون طفل دنماركي (JAMA Otolaryngology 2018)، ارتفع خطر أمراض الجهاز التنفسي العلوي 2-3 أضعاف بعد استئصال اللوزتين أو الزوائد الأنفية
verbatim according to source. Translation by the project; the Arabic wording is authoritative.
Translation
Childhood adenoidectomy or tonsillectomy doubles to triples the risk of upper respiratory disease later in life (Byars 2018, 1.19 million Danish children).
Origin
- Source status
- Archive editors
- Attribution
- Archive editors (eltayebat.com); not necessarily Elawady's own words
- Origin
- https://eltayebat.com/rule/unnecessary-organ-removal/
- Attribution uncertainty
- Editorial summary/narrative and study selection written by the archive operators; the archive states that the cited research documents harm independently of Dr. Diaa's words.
- Claimed mechanism
Loss of lymphoid tissue during immune development.
- Claimed health effect
Respiratory, allergic, infectious disease.
- Population concerned
Children operated before age 9
- Geographic restriction by Elawady
not applicable
Scientific assessment
Potentially true – Some evidence points in favour of the statement, but it is not sufficient for a clear judgement.
Certainty of evidence: low – Further research is likely to change the assessment considerably.
1. What was claimed?
Surgery doubles/triples later respiratory disease.
2. What is demonstrably correct?
The association was reported: RR 1.99 (adenoidectomy) and 2.72 (tonsillectomy) for upper respiratory tract disease; infections RR 1.17 (+2.14% absolute) after adenotonsillectomy (A-ORG-01).
3. What is wrong or exaggerated?
Causal phrasing: the authors note that confounding may not be fully accounted for; children who need these operations may be predisposed to airway disease. Absolute risks are not given by the archive.
4. What remains unclear?
Replication in other populations.
5. Which studies support it?
6. Which studies contradict it?
A-ORG-03, I-ORG-04 (short-term benefits).
7. What applies to Germany and Europe?
Most cited cohorts are Scandinavian (Denmark, Sweden) and directly European; RCTs from the UK and Finland are directly transferable. Guidelines in Europe also emphasize defined indications (not verified here in detail).
8. What is known about Egypt?
No Egypt-specific data on rates or outcomes of tonsillectomy, cholecystectomy, hysterectomy, splenectomy or thyroid surgery were identified in this review.
9. What practical conclusion is appropriate?
Supports considering long-term risks in borderline indications.
Assessment details
- Rationale for certainty of evidence
One very large register study with careful adjustment; confounding by indication possible; not replicated in the evidence reviewed.
- Source quality
Numbers correct; causal wording ('doubled to tripled the risk') stronger than the authors' associational conclusion.
- Regional transferability
Danish data, directly European.
- Individual exceptions
Absolute risk increase small for infections (2.14%).
- Regional scope of the claim
- general (biological/medical)
- Last reviewed
- 25 October 2026 provisional
In plain language
The archive cites a Danish study of 1.2 million children: those who had their adenoids or tonsils removed had about 2-3 times more upper airway diseases later. The numbers are correct. But this kind of study cannot prove that the operation caused the diseases, because children who need these operations may already be more prone to airway problems. The study is a good reason not to operate without a clear indication.
Studies on this claim
Studies supporting the claim (1)
-
Danish children: tonsil/adenoid removal and later illness
Byars SG et al.. JAMA Otolaryngol Head Neck Surg 2018 · PMID 29879264 · DOI 10.1001/jamaoto.2018.0614Cohort studycited by the Tayebat archiveabstract only checked★ key studyChildren who had the operations had more respiratory illnesses later (2-3 times for upper airway disease), but the study cannot prove the operation caused it.
Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Long-term risk
- How was the study done?
Register cohort
- How many people, animals or samples were studied?
1.19 million
- What was actually found?
Associations with later respiratory/infectious/allergic disease
- How large was the observed effect?
RR 1.99-2.72; infections +2.14% absolute
- What do the results mean in everyday life?
A reason to avoid unnecessary operations
- What are the study's limitations?
Confounding
- What does it say about Elawady's specific claim?
Supports a cautious approach, not a ban
- Do the results apply to Germany and Europe?
Directly European
- What can explicitly not be concluded from this study?
That surgery causes the diseases
No study in this group is marked as key.
Studies contradicting or limiting the claim (2)
-
Trial: tonsil/adenoid surgery for children with sleep apnea
Marcus CL et al.. N Engl J Med 2013 · PMID 23692173 · DOI 10.1056/NEJMoa1215881Randomised controlled trialcited by the Tayebat archivefull text checkedSurgery normalized sleep studies in 79% vs 46% with waiting and improved behaviour and quality of life.
Does the study support the specific claim? No · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
OSA treatment
- How was the study done?
RCT
- How many people, animals or samples were studied?
464
- What was actually found?
Symptom, QoL and sleep-study benefit; no cognitive benefit; 46% normalized with waiting
- How large was the observed effect?
79% vs 46%
- What do the results mean in everyday life?
Surgery helps children with sleep apnea
- What are the study's limitations?
7 months
- What does it say about Elawady's specific claim?
Contradicts blanket rejection of surgery, but supports watchful waiting as a valid option for many children
- Do the results apply to Germany and Europe?
Applicable
- What can explicitly not be concluded from this study?
Long-term cognition
-
Cochrane review: tonsil removal for repeated throat infections
Burton MJ et al.. Cochrane Database Syst Rev 2014 · PMID 25407135 · DOI 10.1002/14651858.CD001802.pub3Systematic reviewindependent cross-checkabstract only checked★ key studySurgery reduced sore throats modestly in the first year (about 0.6 episodes fewer in children); many children get better without surgery.
Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Effectiveness
- How was the study done?
Cochrane review
- How many people, animals or samples were studied?
1143
- What was actually found?
Modest benefit
- How large was the observed effect?
0.6 fewer episodes
- What do the results mean in everyday life?
Surgery helps a little, mainly in severe cases
- What are the study's limitations?
Short follow-up
- What does it say about Elawady's specific claim?
Supports caution, not a ban
- Do the results apply to Germany and Europe?
Applicable
- What can explicitly not be concluded from this study?
Long-term effects
No study in this group is marked as key.
Studies with mixed or unclear results (0)
No studies in this group.
Regional context
Germany / EU
Most cited cohorts are Scandinavian (Denmark, Sweden) and directly European; RCTs from the UK and Finland are directly transferable. Guidelines in Europe also emphasize defined indications (not verified here in detail).
Egypt
No Egypt-specific data on rates or outcomes of tonsillectomy, cholecystectomy, hysterectomy, splenectomy or thyroid surgery were identified in this review.
What applies in my country?
General scientific assessment
Potentially true Association correct; causation uncertain.
This statement concerns biological or medical relationships. The scientific assessment above applies regardless of the country; country-specific food data do not change it.
References
- Association of Long-Term Risk of Respiratory, Allergic, and Infectious Diseases With Removal of Adenoids and Tonsils in Childhood.. Byars SG et al.. JAMA Otolaryngol Head Neck Surg 2018 · PMID 29879264 · DOI 10.1001/jamaoto.2018.0614
- A randomized trial of adenotonsillectomy for childhood sleep apnea.. Marcus CL et al.. N Engl J Med 2013 · PMID 23692173 · DOI 10.1056/NEJMoa1215881
- Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis.. Burton MJ et al.. Cochrane Database Syst Rev 2014 · PMID 25407135 · DOI 10.1002/14651858.CD001802.pub3