The T's and A's problem in N.W.F.P.

Tonsils are not just easily accessible lumps of lymphoid tissue to be disposed off. They have useful function in childhood and theft removal may cause problem later due to lack of immunity. There has been great opposition to the surgical treatment of tonsils. According to Calderoli, ‘it is an ugly, barbarous, painful, cruel, repulsive, dangerous and largely useless operation much more so than the simple cutting of a dog’s tail”. However inspite of all the arguments and oppositions, over 2 million tonsillectomies are done each year in the United States. 3 The management of tonsils and adenoids has always been a controversial issue between physicians and surgeons with both baving firm opinions about their own approaches. The pae-diatricians. and family physicians however come to an agreement with the otolaryngologists in favour of surgical treatment after a careful assessment. It has been estimated that less than one tenth of the total patients examined with a history of sore throat will need surgical treatment. The indication for tonsillectomyin this study were recurrent sore throats for at least 2-3 weeks each year, one attack of quinsy and small children under the age of 5, with large tonsils causing nocturnal dyspnoea, general ill health and frequent upper respiratory tract infections.