How Do I Know If I Need To Have My Tonsils Removed?

All you need to know about the two lumps of tissue lying either side of your throat.

If you suffer from frequent tonsillitis (five to six times a year), it is an indication that you do need tonsillectomy (removal of tonsils). Your doctor would need to confirm that it is tonsillitis and not just a pharyngitis (generalised sore throat) before turning to surgery.

Apharyngitis is usually a viral infection which will continue to occur even after tonsils are removed. We also remove tonsils if they are very large and cause obstruction, especially at night when the patient sleeps (obstructive sleep apnoea).

Sometimes, tonsils are removed because of suspicion of cancer, especially if one tonsil is much bigger than the other or if there is bleeding. To avoid surgery, we will have to look for underlying causes to treat.

A swab can be taken from the tonsils during an infection and sent to the laboratory for the identification of underlying bacteria. The appropriate antibiotic should then be given for two weeks to try to eradicate the bacteria. Sometimes, the patient has underlying nasal allergies.

If present, this should be treated aggressively so that the patient can breathe naturally through the nose instead of the mouth. Children have a better chance of avoiding surgery, especially as the immune system matures. For adults, even if infections become less frequent, surgery might still have to be considered if they remain large and cause obstruction.

The usual advice of taking lots of fluids, fruits, vitamin C and exercise will help boost the immune system and reduce the frequency of viral infections, but it will probably not be effective for tonsillitis.

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