Each week, OMRF Chief Medical Officer Dr. Judith James opens “Adam’s Journal” to answer a medical question from Adam Cohen, OMRF’s senior vice president & general counsel.
Adam’s Journal
My adult son has had several tonsil infections this year, and he mentioned that he’s thinking of having his tonsils removed.
When I was growing up, it seemed like every other kid I knew had this procedure, but now it seems much rarer. When should a person have their tonsils removed?
Dr. James Prescribes
Tonsillectomies, the surgical removal of the tonsils, were once so commonplace that entire hospitals were devoted to the procedure. (For example, in 1921, the now-defunct Tonsil Hospital opened in New York with the mission of removing the tonsils and adenoids of underprivileged children on the East Side of Manhattan.)
Doctors routinely recommended the procedure to treat infection of the tonsils (tonsillitis), especially in children. But with the rise of evidence-based medicine, use of the surgery ebbed.
Investigation found that most children outgrow the infections even without the procedure. In addition, a 2018 study determined that, after controlling for other health factors, adults who’d had tonsillectomies as children ended up with almost three times the risk of upper respiratory disease as those who’d kept their tonsils.
Today, doctors continue to perform tonsillectomies, but they largely do so in three circumstances: to help alleviate breathing-associated sleep disorders; to eliminate tonsil stones, which are small lumps that form on some people’s tonsils; and to treat recurring episodes of tonsillitis, which generally means quite a few infections cropping up at regular intervals over a period of a year or more.
As in the past, the procedure is still performed predominantly in children. And while the number of surgeries has diminished, it remains far from rare, with estimates placing the annual number in the U.S. around a half-million.
Unlike in the past, when it comes to tonsil infections, doctors are much more likely to employ a watch-and-wait approach. That means only resorting to surgery, which brings risks, when they determine that infections recur often and cannot be treated through other means, such as antibiotics and medications to manage pain.
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Do you have a health query for Dr. James? Email contact@omrf.org and your question may be answered in a future column!
