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Q
Should Tonsils and Adenoids Be Removed?

I'm 22 and have been referred to an ear, nose, and throat (ENT) specialist to remove my tonsils and adenoids because I've had so many problems this year. What are the pros and cons of this procedure?

A
Answer (Published 1/16/2002)

Tonsils are small masses of tissue on either side of the back of the throat - you can sometimes see them by looking down your throat in front of a mirror. Adenoids are located high in the throat behind the nose, and even doctors can't see them without special instruments. Both are parts of the immune system (which can still function well without them). Once, tonsils and adenoids were routinely removed in children after repeated bouts of infection (tonsillitis). Although this is less common today, doctors still recommend surgery if someone suffers from frequent infections.

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Because of their location, tonsils and adenoids can easily become infected by inhaled bacteria and viruses, which can cause sore throats, fever, and bad breath. Although this happens most often in children, adults are not immune. Infected tonsils and adenoids may also become enlarged, which can result in breathing and swallowing difficulties. Bacterial infections can be treated with antibiotics, but surgery may be needed when other treatments fail to work.

Since you haven't described the exact problems you've been having with your tonsils and adenoids, I can't make any specific recommendation. In general, however, whenever surgery is recommended, it's best to get a second opinion about whether it's warranted. The principal risks of the surgery are bleeding during or after the procedure. This happens in about one out of 100 cases and may require a transfusion. The risk of death from bleeding is very small, one out of 35,000 cases. Adverse reactions to anesthesia occur in only one out of 10,000 tonsillectomies and adenoidectomies.

On the plus side, today tonsilectomy is usually an outpatient procedure although it still must be done in the hospital under general anesthesia. Even better, the surgery should put an end to the problems you've been experiencing.

Andrew Weil, M.D.

Related Links:
Tonsils and Adenoids Explained

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