What is tonsillitis?
The tonsils are structures which are on the sides of the upper throat, or pharynx, at the back of the mouth. They are areas where certain white blood cells congregate, and where some of the lymph flow from the mouth and nose are filtered so that the body can deal with bacterial or viral infections.
When there is an infection in the tonsils, that is called tonsillitis. Under normal circumstances, the tonsils deal with infections quite well, and although there may be some soreness, the patient recovers quickly without intervention. Streptococcus (Strep) infections are somewhat more difficult to handle, and antibiotics are used to help with both the tonsillitis and to prevent the development of rheumatic fever, rheumatic heart disease, kidney disease, and scarlet fever.
In some patients, repeated infections can lead to scarring in the tonsils, which decreases the blood supply and therefore the tonsil’s ability to fight infection. When this happens, the bouts of tonsillitis may become more frequent and severe. This is known as chronic or recurrent tonsillitis. In other patients, the acute infection can spread to the area surrounding the tonsil, forming what is known as a peri-tonsillar abscess. These need to be drained surgically.
How is tonsillitis treated?
Chronic tonsillitis is treated with prolonged courses of antibiotics, perhaps up to several weeks. Despite this treatment, some patients will have continued relapses, because the scarred tissue cannot be completely freed of the bacteria. This is when tonsillectomy is considered.
What is a tonsillectomy?
A tonsillectomy is the surgical removal of the tonsils. This is usually performed in an operating room under general anesthesia. In most cases the patient can go home the same day. A liquid diet is required for several days, and eating is somewhat difficult for 2-3 weeks.
Does removing tonsils lead to any long-term problems?
Not that we know of. There have been millions and millions of tonsillectomies done over the past 100 years, and so we have a large sample of people who have been studied. There are no increases in any type of infection or tumors, and in fact there are some tumors which are less common in people post-tonsillectomy. The remaining lymph nodes in the neck (dozens on each side) deal effectively with the usual upper respiratory infections.