Are Tonsillectomy Procedures Necessary?
Many older adults today have had a tonsillectomy (surgical removal of the tonsils at the back of the throat). The frequency of tonsillectomy procedures peaked in popularity from the late 1950s through the 1970s as a treatment for children with frequent or recurring sore throats (tonsiliitis). Since the heyday of tonsillectomy in the 70s, the tonsillectomy rate has declined by about 75%, from about 1 million per year to just around 250,000. The reason for this decline is a growing skepticism on the part of both doctors and parents that the procedure has benefit for most people in helping control infections. Even a major research study in 2004 showed that many, if not most, tonsillectomies, might not be necessary at all.
The operation itself is a fairly simple procedure with relatively few risks of serious consequences. Still, infection, bleeding, and complications from the anesthetic drugs are a potential risk of any surgical operation. Most children who have a tonsillectomy will need to miss at least a week of school, and there is usually some degree of discomfort in the days following the procedure.
When Is Tonsillectomy Reccommended?
While doctors may still debate the necessity for tonsillectomy and its effectiveness as a treatment, there are certain circumstances for which the tonsillectomy is definitely recommended, including:
- Sleep apnea, a condition in which breathing is temporarily interrupted at night. Sleep apnea can be caused by markedly enlarged tonsils and is usually accompanied by heavy snoring
- Any degree of airway obstruction or swallowing problems caused by enlarged tonsils
- An abscess around the tonsils (peritonsillar abscess) that has not been cured by drainage and medical management
- Tonsil infection that results in febrile seizures
- Tonsil stones that cause bad breath
- Any suspicion of cancer (very rare) in the area or another need for a biopsy to establish a diagnosis
In other situations, such as a high frequency of throat infections (more than 5-6 sore throat infections per year) or very severe infections, a tonsillectomy may be considered. The type and severity of infections as well as their response to antibiotics is taken into consideration when deciding whether a tonsillectomy might be appropriate for an individual patient.
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