It’s a pretty easy picture to paint. A child, home from school, eating ice cream and sitting on the couch, recovering from having their tonsils removed. A couple of generations ago it seemed like everyone was told to get their tonsils out. There’s a reason. At that time, the first big socialization of kids occurred when they showed up for kindergarten. At age 5, the weak link in your body and health is the tonsils. Poor immunity to strep throat meant many children were exposed, became infected, and needed surgery. Nowadays, kids are often placed in daycare a couple of months after birth and begin socializing earlier in life. Another weak link in very young children is the ear, which is why ear infections are the bane of existence for parents trying to get back to work shortly after their children are born. It is also why it seems like ear tubes are a veritable rite of passage for daycare children. Conversely, this is also why it seems like fewer kids are having their tonsils removed. By the time they get to kindergarten, they have better immunity. Back in the day, all of the children seemed to get strep throat frequently making tonsillectomy more prevalent. This is no longer as much of an issue, because their immunity is built up.
Another main reason one might need a tonsillectomy aside from childhood strep throat relates to the airway. Younger children with obstructive apnea usually have the adenoids and tonsils to blame. Children, whose faces are developing as they grow, can have lengthening of the mid-face due to nasal obstruction from enlarged adenoids and tonsils. This is because the oral cavity “takes over” the nasal airway by the hard palate (roof of the mouth) actually rising. Significant orthodontic problems occur as a result. Another example occurs when teenagers get mononucleosis, which frequently dramatically enlarges the glands and can lead to acute airway obstruction.
One of the main reasons that adults have their tonsils removed is the presence of tonsillar stones. The tonsils trap bacteria as part of their function in garnering the elements of the immune system to create antibodies to harmful organisms. However, as an adult, this function isn’t very active. Also, the bacteria may grow in debris within the tonsil, with the deep crypts actually accumulating harmful bacteria along with bits of food. These bacteria shed dead tonsillar tissue to make little “sedimentary rocks”. The very presence of these foul particles is inflammatory. The chronic infection that they represent is sometimes under-appreciated. Not only do these stones reek foul odor, they can be the source of throat discomfort and pain to the ear. Chronic inflammation from the stones could also possibly be a contributing factor inciting tonsil cancer, although this is not scientifically confirmed to date.
Additionally, adults with obstructive sleep apnea often have enlarged tonsils as part of the problem. This is further evidence that tonsillitis is not just an issue that affects children. This condition can affect individuals of many different ages, and it is important to know the facts!