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The tonsils are lymph nodes that are located in the back of the throat

They are part of the immune system of the body and they do not possess any special features related to their position, specially, there is no evidence to suggest that they pick up the bacteria as it enters the mouth. The size of the tonsils fluctuates dramatically depending on the age of the patient and in the presence of an infection.


There are two problems that could be associated with the tonsils and adenoids:

  1. Large tonsils could block off the air and food passage behind the throat. This usually exhibits itself in children and could cause persistent obstruction of the nose and persistent breathing though the mouth.
  2. Recurrent infections of the tonsils: the surface of the tonsils contains many small pockets that tend to accumulate dead skin and food debris. These pockets are very good areas for the bacterial growth. Bacteria will then gain access to the tonsils themselves and cause an infection.

When the patient takes antibiotic, it goes through the blood to the tonsils and clears the infection. However, the pockets on the surface of the tonsils will continue to have bacteria since the blood and antibiotics do not have access to these areas that do not have any blood vessels. This in turn causes recurrent infections from these pockets.

The only implication of recurrent infections of the tonsils in the pain and discomfort associated with these recurrent infections. Heart disease secondary to rheumatic fever does not occur except in cases where these infections have been ignored for a long time, usually in areas where medical care is inadequate.


There are two indications for removal of Tonsils and adenoids:

  1. Definitive indications or reasons: Sleep Apnea, or the patient ceasing to breath at night time for few seconds secondary to the enlarged tonsils and adenoids.
  2. Relative indications: such as recurrent infections or nasal obstruction that is not causing sleep apnea. The decision to proceed with tonsillectomy is tied up to the frequency of these infections and how much of a problem it is for the patient.


When lymph nodes are removed, the body will usually compensate and regenerate to cope with the loss. Although some people have raised theoretical concerns about the removal of tonsils, there have been many studies to look at any ill effects of removal of the tonsils and there is no reason to believe that the surgery that has performed routinely for the last few hundred years is harmful for the human body.

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