Do Tonsils Serve Any Purpose? Tonsil Health and Surgery

Is it true that the tonsils are useless?

Hello Doctor: I experienced tonsillar abscess and a fever of 39 degrees Celsius in January and March of this year.
I took Cruam antibiotics for three weeks each time before recovering.
During the March episode, I also received intravenous Cefazolin to control the infection.
Since then, I have had a persistent sensation of something stuck in my left throat, especially when yawning.
Recently, my throat has started to feel strange again.
I would like to ask the doctor: 1.
Is it possible to permanently resolve recurrent tonsillitis by removing the tonsils? 2.
Will my immune system be weaker after tonsillectomy, since I have heard that the tonsils produce T cells? 3.
How many episodes of tonsillar abscess with high fever in a year would typically lead a doctor to recommend tonsillectomy? 4.
Are there any maintenance and preventive measures for recurrent tonsillitis? Thank you, doctor!

Betty, 30~39 year old female. Ask Date: 2016/06/17

Dr. Ji Zhaoyun reply Otolaryngology

Hello, regarding the conditions for tonsillectomy that you mentioned, they are generally as follows: 1) Enlarged tonsils causing breathing difficulties or conditions such as obstructive sleep apnea; 2) Presence of malignant tumors; 3) Recurrent tonsillitis (as you mentioned in your text).
Internationally recognized criteria for recurrent tonsillitis include: a) More than 7 episodes of tonsillitis in one year; b) More than 5 episodes per year for two consecutive years; c) More than 3 episodes per year for three consecutive years.
If these criteria are met, tonsillectomy is recommended.
After tonsillectomy, individuals will no longer experience tonsillitis with subsequent colds.
The immune function of the tonsils (such as T-cell production) primarily occurs during childhood; therefore, if an adult has medical indications (as mentioned above), tonsillectomy can be performed.
If you are still uncertain about whether to proceed with the tonsillectomy, it is advisable to maintain good oral hygiene by rinsing your mouth after meals, which can help clear some tonsil stones (located in the tonsillar crypts).
Additionally, try to avoid colds, and seek medical attention promptly if you do catch a cold, as these measures can reduce the likelihood of tonsillitis.
Wishing you peace and good health.
Sincerely, Dr.
Chi Chao-Yun, Head of the ENT Department, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2016/06/17

More Info

Tonsils, often overlooked, play a significant role in our immune system, particularly during childhood. They are part of the lymphatic system and help in fighting infections by producing antibodies and trapping pathogens that enter through the mouth and nose. However, their importance can diminish as we age, and recurrent infections can lead to the consideration of surgical removal, known as tonsillectomy.

1. Recurrent Tonsillitis and Tonsillectomy: If you have experienced multiple episodes of tonsillitis, especially with complications like abscess formation or severe symptoms requiring intravenous antibiotics, a tonsillectomy may be recommended. The general guideline suggests considering surgery if a patient has had seven or more episodes of tonsillitis in one year, five episodes per year for two consecutive years, or three episodes per year for three consecutive years. The surgery can provide a long-term solution to recurrent infections, significantly reducing the frequency and severity of throat infections.

2. Impact on Immune Function: There is a common concern that removing the tonsils may weaken the immune system since they are involved in producing immune cells, including T-cells. However, research indicates that while tonsils do contribute to immune function, their removal does not significantly impair overall immunity. The body has other mechanisms and organs, such as lymph nodes and the spleen, that compensate for the loss of tonsils. Most individuals adapt well post-surgery, and the risk of infections does not increase.

3. Criteria for Surgery: The decision to recommend a tonsillectomy is based on the frequency and severity of infections, the impact on quality of life, and any complications arising from the infections. If you find that your episodes of tonsillitis are frequent and debilitating, it is reasonable to discuss surgical options with your healthcare provider. They will consider your medical history, the severity of your symptoms, and any other health factors before making a recommendation.

4. Prevention and Care: To reduce the frequency of tonsillitis, several preventive measures can be taken. Maintaining good hygiene, such as regular handwashing, avoiding close contact with sick individuals, and ensuring vaccinations are up to date, can help. Staying hydrated, avoiding irritants like smoke, and managing allergies can also contribute to throat health. Additionally, a balanced diet rich in vitamins and minerals supports the immune system. If you are prone to throat infections, consider discussing with your doctor about preventive antibiotics during high-risk periods or exploring other underlying health issues that may contribute to recurrent infections.

In summary, while tonsils do serve a purpose in our immune system, their removal can be a beneficial option for those suffering from recurrent infections. The decision to undergo a tonsillectomy should be made in consultation with a healthcare professional, considering the frequency of infections and overall health. Post-surgery, most individuals do not experience a decline in immune function and often enjoy a better quality of life free from the burden of recurrent tonsillitis.

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