Why Are Tonsils Removed?

In the first in a series of videos directly from the desk of Dr. Hester, we look at some common questions people ask. The first, “Why Are Tonsils Removed” is one of the more common questions we get. In this video Dr. Hester will explore this procedure. For those who would rather read than watch the video, a transcript of the video appears on this page.

A generation or two ago, many times tonsils were removed for somewhat vague reasons, either just based on appearance, in general, or some mild symptoms. Subsequent to that, with increased study, decisions were made to markedly reduce the number of tonsillectomies performed. Many times, individuals who were truly suffering from those issues were told that they should not have their tonsils out.

Within approximately the last decade, more concise and, I believe, more accurate recommendations for tonsillectomy have evolved. They basically come down to two reasons. The first is recurrent infection. There are definite parameters over how many infections in one year or how many infections over two to three years and individual would have before removal of the tonsils appeared to be indicated.

However, also something must be taken into consideration regarding the severity of these attacks. In other words, how sick is the patient during the attacks? How much school or work are they missing during these, which may prompt an earlier removal of the tonsil.

It is also important to know that although a Strep test, which is a test done commonly to measure a certain type of bacteria in a tonsil, may or may not be positive even in those individuals where the Strep test is negative. Removal may be indicated due to the presence of other organisms causing the infection.

Interestingly, over the last several years, however, the more common reason to remove tonsils is due to obstruction. This is not to say the tonsils are removed simply due to their size. However, we do know that large tonsils, especially in the young child or adult, can lead to obstruction of the airway, causing disruption of breathing during sleep. It has become the most common reason for tonsil removal, even in the individuals who never have tonsil infections.