Tonsils are part of the immune system and trap harmful substances before they enter the body. Children have larger tonsils, and severe infections may require removal, but doctors are now more reluctant to recommend it as it can compromise the immune system. Tonsils can also be removed for breathing or chewing difficulties.
Tonsils are masses of lymphoid tissue that line the mouth and throat opening. They are designed to trap bacteria, viruses and other harmful substances before they enter the respiratory system and the rest of the body. Because they work to reduce and fight infection, tonsils are considered part of the immune system.
Many people are familiar with the palatine tonsils, which hang down in the back of the throat behind the tongue. Additionally, people also have pharyngeal tonsils, also known as adenoids; these line the palate. Tonsils are also found at the back of the tongue, in the form of lingual tonsils, and in the Eustachian tube, which connects the pharynx to the ear. Collectively, they are known as the tonsillar ring of Waldeyer.
Children tend to have larger tonsils because these tissues atrophy with age. Consequently, when those of children have become infected, it is much more evident. Tonsil infections cause the tissue to swell, often causing pain or tenderness, and once they’ve been infected once, the tonsils can easily become infected again. For this reason, children with severe tonsil infections, known as tonsillitis, or repeated infections may have them removed.
At one time, tonsil removal was more widely practiced, because their function was imperfectly understood. Now that doctors understand the role of the tonsils in the immune system, they tend to be more reluctant to recommend removal, as it can compromise the immune system, leading to more serious infections later. If they survive into infancy, potential infections will be less apparent, and tissue preservation will help fight disease in general.
Tonsils can be removed for reasons other than infection. Sometimes the tissue becomes so large and swollen that it inhibits breathing, causing sleep apnea or snoring. In these cases, removal of the palatine tonsils is recommended for health and comfort. They can also be removed in cases where people find it difficult to chew. Many surgeons offer intracapsular tonsillectomy, which involves removing only a portion of the tissue, leaving some material behind to protect the patient from future infection.
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