Host: A lot of kids seem to get a lot of sore throats and sometimes not as much as we used to, they sometimes get a surgery for it. Why is that?
Ari Goldsmith: If children are getting a lot of throat infections what we call tonsillitis, where the tonsils get infected and it's happening too many times and the child is suffering from it. There are lot of antibiotics, they are missing school. At some point, we would consider tonsillectomy, which is a very old safe procedure where we take out tonsils.
Host: Back in 1982, an English Journal Medicine had an article published and before that -- but it seemed everybody got a tonsillectomy surgery, some of you didn't. You know the article I am referring to? What changed things? Why we do at one day and suddenly we seem not to do as many?
Ari Goldsmith: What they found is that in children that were having a certain about strep infections or sore throats pretty year, which they define as significant, which they defined as seven infections a year for one year, five infections a year for two years, three infections a year for three years. Those kids that they had their tonsils taken out did better. However, if it's less than that, they do not feel that it was necessary and that kind of revolutionized our indications for tonsillectomy for infection reasons. There are other reasons why kids get their tonsils out, breathing problems or obstructive breathing, snoring and gasping, but as far as infections are concerned, we use those criteria to decide and help us to decide if the child needs tonsillectomy.
Host: Why do we have tonsils in the first place, God doesn't create a body and give us something -- there must be a reason?
Ari Goldsmith: Well, tonsils are part of the body's immune system, just like the appendix is, just like limp glands neck and tonsils actually help fight infection because as things are breathed into the mouth, the tonsils help find those little viruses and stuff, it helps fight the infection. However, In some case the system backfires wherein so the tonsils serving as a protection for the body, it serves as a focus of bacteria and infection that actually harms the immune system of there and in those cases we would consider taking the tonsils out.
Host: Is a tonsillectomy a risky surgery?
Ari Goldsmith: Tonsillectomy is a very safe procedure, done from very, very long time. There is a one risk of tonsillectomy and not as significance and that bleeding and that bleeding happens in about 2% or 3% of cases. It happens normally about a week or so after the procedure, and if it happens, it's something that we could help. But it can be very scary for the child. So that's the reason why we try to avoid tonsillectomy if not necessary.
Host: What are the risk of anesthesia, is there any major risk of anesthesia today?
Ari Goldsmith: Anesthesia, when performed by a pediatric anesthesiologist and otherwise healthy child has no major risks at all. Any stories we hear of are simply that they are stories. Kids do very well, it's very routine not for the parents of the child, but it's very routine for the healthcare team and the general kids do very well with anesthesia.
Host: Thank you very much.
Ari Goldsmith: You are welcome.
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