on port injection engines they are mainly a sing that the engine is breathing excessivly and needs new rings.
but on TFSI engines IMO your a tard if you don't fit one. as fuel isnt injected in the ports it dosent hit the valves and help clean the oil residue from the breathers off them so instead bakes in to rock hard gunk eventualy it starts o cause problems by blocking the port and makeing the valves heavyer it can also affect the ablity of the valves to seal.
so engine output can drop off lots, seen some TFSI heads that are affully gunked up at sub 50k miles and have lost significant amounts of power from it were talking 40+ bhp