Is It Bad to Have the Tonsils Removed?

Tonsils are two protruding tissue masses at the back of your throat. Concerns associated with removing the tonsils include immunity issues and the potential for antibiotic advancement.

Tonsils are the two protruding tissue masses at the back of your throat. They are the first defense system against bacteria that we ingest or inhale. There are three types of tonsils in the back of the mouth

• Palatine tonsils: It is located at the back of the mouth in the fauces below the soft palate. Mostly, tonsils refer to the palatine tonsils.
• Lingual tonsils: It is located at the base of the tongue.
• Pharyngeal tonsils/adenoid: It is located high up in the throat, just behind the nose.

Tonsillectomy, although a common surgery, has earned a bad reputation for several reasons. A few studies have reported that tonsillectomies and adenoidectomies are associated with higher levels of allergic, respiratory, and infectious diseases later in life. This statement is however disputed by an equal number of studies.

Tonsillectomy means the removal of the tonsils from the back of your throat. It is still considered one of the most common surgical procedures performed in children. However, it remained controversial because of the following reasons:

• Immunity concern: The tonsils produce a type of lymphocyte (white blood cell) that helps fight against infection and is active in the synthesis of immunoglobulin (a protein that filters out microbes, bacteria, and viruses). Therefore, they play a role in immunity. Although healthy tonsils offer immune protection, diseased tonsils are less effective at serving the same immune functions. Infected tonsils may be unable to respond to other antigens. It cannot appropriately reinforce the special surface immune system of the respiratory tract. Some studies have demonstrated minor alterations of the immunoglobulin level in the blood serum following a tonsillectomy. However, there is no evidence of a significant clinical effect of a tonsillectomy on the immune system. In cases of recurrent tonsillar infections, the benefits of a tonsillectomy clearly outweigh the risks.
• Antibiotic advancement: Streptococci bacteria is one of the main culprits causing your tonsillar problem. It causes a strep throat, and this may cause people to get numerous tonsil infections, even several per year. Before the advent of modern antibiotics, a tonsillectomy was the best available treatment for reducing the risk of this painful throat condition. With the introduction of antibiotics, tonsillitis has now become easier to treat with antibiotics as opposed to surgery. Therefore, surgery is not always advisable. Recurrent group A streptococcal (GAS) pharyngitis gets complicated by one or more of the following
  • Multiple antibiotic allergy/intolerance
  • Peritonsillar abscess or quinsy
  • A history of rheumatic heart disease or close contact with a person with a history of rheumatic heart disease
  • Tonsillar obstruction of the oropharynx that interferes with swallowing

Severe obstruction due to adenoidal hypertrophy is an absolute indication for surgery. An adenotonsillectomy is preferred over an adenoidectomy alone in this setting.

Only after watchful waiting, the pediatrician may recommend a tonsillectomy if your child has

• A recurrent throat infection and sore throat, despite adequate medication with at least
  • Seven episodes in the past year
  • Five episodes per year in the past two years
  • Three episodes per year in the past three years
• Nighttime breathing problems with snoring
• Trouble breathing or swallowing
• Enlarged tonsils
• Abscess in tonsils
• A tonsil tumor
• Otitis media or recurrent middle ear infections due to colds

The complications of a tonsillectomy are as follows

• Bleeding
• Anesthesia complications
• Pain
• Sore throat
• Ear pain
• Altered taste
• Tongue swelling
• Throat infection
• Respiratory depression
• Injury to the mouth
• Weight loss
• Voice changes
• Lung swelling
• Death (rare)