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[ JBEM Index / Volume 5 / Number 4 ]

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Letters to the Editor

Dear Editor,

I read with interest Randall Crenshaw's article "Can Anyone Heal Me?" in Volume 5, No. 3. There is no doubt to the underlying truth of the basic tenet of Dr. Crenshaw's article that many of our ailments are caused by spiritual problems and that help is often sought from physicians who either don't know how to help or cover up the problem with medicine and surgery.

However, his paragraph regarding tonsillectomies is either uninformed or using very old data to try to prove a point. As a Christian Otolaryngologist I know that tonsillectomy is no longer the most common operation performed in the United States as this has been surpassed by the placement of ventilation tubes for serous otitis media refractory for medical treatment. I would tremble with fear if it was true that one out of every thousand tonsillectomy patients dies. It is true that there is one report in the literature with a death rate of 1/1000, but all the recent literature suggests a death rate of 1/10,000 -- 1/15,000. Moreover, there are several studies reporting no deaths in more than 170,000 operations. Serious complications are nearly all due to bleeding and may require transfusion in 1 0 2 %. Furthermore, there are approximately 800,000 tonsillectomies done per year in the United States which includes a significant percentage of adults who have persistent tonsil disease. Simple mathematics make it clear that nowhere near 20 - 30% of American children have their tonsils removed.

Finally, his assertion that 50 - 95% of tonsillectomies are unnecessary requires further qualification. A tonsillectomy is nearly always an elective procedure designed to improve the quality of life for that individual. It is, however, elective in almost all cases except severe obstruction. With more stringent criteria in use today nearly all patients having tonsillectomies obtain significant benefit.

For those who are interested in this subject there is a comprehensive review with extensive literature, references in the 1987 Otolaryngologic Clinics of North America (May 1987, Vol. 20. 2). This should be available in nearly any hospital library, or ask your local Otolaryngologist.

As a Christian, we must strive for truth in all aspects of communication.

Sincerely,

Scott Voorman, M.D.

Simi Valley, CA

[ JBEM Index / Volume 5 / Number 4 ]

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