Tonsillectomy, or tonsil removal, used to be a very common operation, almost a rite of passage for a child under the age of ten. It’s done less frequently now, but still done; it’s still one of the most common childhood surgeries. If a child has recurring sore throats and inflamed tonsils, a tonsillectomy is often recommended. But should you have it done? Here are some things to consider.
What and where are the tonsils?
Tonsils are small soft masses of tissue on either side of the throat. Although there are several groups of tonsils, these, called palatine tonsils, are the ones usually referred to and removed in a tonsillectomy. The adenoids, also considered to be tonsils, are often removed as well. Adenoids are located farther up, between the nose and the throat. Tonsils, but not adenoids, can be easily seen if you look in your child’s mouth with a flashlight.
Why is removal considered?
Tonsils often get infected, red, inflamed, and sore, and pus can sometimes be seen on the tonsil surface. The inflammation, called tonsillitis, can be acute, coming on fairly quickly in response to bacterial (such as strep) or viral infection. It may go away by itself if viral, or with antibiotics if bacterial. It may become chronic, coming on frequently or lasting a long time. When sore throats are severe and/or recurrent, along with tonsil inflammation, the doctor might recommend removal. Another indication for removal might be noninfectious swelling that can cause snoring and affect the voice.
If the tonsils aren’t there, they can’t get infected, right? Or at least that’s the usual thinking.
What is the purpose of tonsils?
Before considering their removal, it’s important to know what tonsils do in the first place.
Tonsils are part of the immune system. They are lymphatic tissue, and like all lymphatic tissue found in the body, they help to process and eliminate toxins and infections before the toxins can affect the whole body. They are in a way the guardians at the gate of the throat, the first line of defense, catching various nasties before they enter the body via swallowing or breathing.
Why shouldn’t the tonsils be removed?
Tonsils are there for a reason, and that reason wasn’t fully known back when tonsillectomy was so popular that few children survived childhood with their tonsils intact back in the 1950s and 1960s. The operation was even done on children who didn’t have problems just as a precaution. But tonsils are an important part of the immune system, and in most cases should be left alone to do their job. Think about it: if the tonsils become inflamed because they’re protecting the rest of the body, what happens to that inflammation or infection if the tonsils aren’t there to bear the brunt of it? In a way, the inflamed tonsils are like the oil pressure light in a car. Removing the tonsils is like disabling the car light, which of course doesn’t help what’s really going on. You won’t have those sore throats, but what will you have instead? Restated, removing the tonsils removes just the symptom, not the underlying problem.
Another reason not to remove the tonsils is that most children outgrow their tonsil problems, whether infectious or noninfectious swelling. Just wait it out, and the child will have the benefit of tonsils for the rest of her or his life. In fact, the outgrowing of such problems is one of the reasons that tonsillectomy appears to be so successful: the problem would have gone away with time anyway. This is the major reason why adults who made it to adulthood with their tonsils intact very rarely need or have the procedure as adults.
A third reason to avoid tonsillectomy is that any surgery has risks – bleeding, infection, or allergic reactions to anesthesia. Even a slight risk needs to be weighed against any benefit, and this is the case when considering any surgery, or in fact any medical procedure. Yes, the operation is simple and the risk is low, but low isn’t the same as zero.
What are some alternatives to tonsillectomy?
The first thing to do is to ask why the tonsils are getting infected in the first place, or why the child gets so many sore throats.
One cause of sore throats, tonsil inflammation, and ear infections (which are related) is sensitivity to dairy products. Removing milk, yogurt, and cheese from the child’s diet can often contribute to significant improvement in just a few weeks.
Another cause is parasite infection. Often the acute infection, such as by the strep bacteria, is treated with antibiotics, but there may be an underlying infection such as roundworm that hasn’t been identified and addressed.
Dental infections can affect the nearby lymph tissue, including both the tonsils and the lymph glands in the neck. A checkup by a knowledgeable dentist might uncover the underlying problem.
The immune system might not be working optimally, and there are many reasons for this, from chemical overload to food allergies to poor nutrition.
The practitioners at CAM can help to figure out and address the cause of recurrent tonsillitis. It’s much better to have healthy tonsils than no tonsils.
Is tonsillectomy ever a good idea?
There are still indications for tonsillectomy. Sometimes there are recurrent abscesses around the tonsils. In some cases the tonsils get so large that they interfere with breathing, especially during sleep when the child is lying down. Children shouldn’t snore; if they do, this might be an indication of sleep apnea caused by enlarged tonsils. Inflamed tonsils and adenoids can contribute to impaired and nasal-sounding speech. But even in these cases it’s a good idea to see what else is going on in the way of root cause before picking up a scalpel and making a permanent change.
