Tonsils: Leave ‘Em In Or Yank ‘Em Out?
Recent Blog Entries From Dr. Dave Hnida
Doctors have been yanking out tonsils for a long time – as in 3,000 years plus, but surprisingly, there have never been any set guidelines on just when those overgrown tomatoes should be coming out. At least until now.
The American Academy of Otolaryngology ( Ear, Nose, and Throat for those who can’t spit the word out) has just issued the first ever set of “when-to’s” for American doctors and parents.
And they are guidelines that are certainly needed. It seems many decades ago, every kid got their tonsils out.
Then back in the 70s, 80s, and 90s, no one did. Now we’re back somewhere in the middle, which seems appropriate. And necessary, too when you consider more than 530,000 sets of tonsils get pulled every year. (It is, in fact the No. 3 medical procedure on kids, right behind ear tubes,which scare the heck out of parents, and circumcisions, which would scare the heck out of babies if they knew what was coming.)
By the way, what are tonsils, anyway? Actually “lymphoid tissue” meaning they are made of the same material as lymph nodes, or glands — and like many things in the body (see “appendix”), you can live without them. Some kids just get tonsils that over-swell in response to fighting an infection, and some stay big even after the infection is long gone.
So here’s what the Academy had to say about when tonsils should say goodbye:
- Seven episodes on tonsillitis in one year
- Five episodes in each year, two years in a row
- Three episodes per year in three consecutive years.
And we’re not talking low-grade scratchy throats here. The cases of tonsillitis should make a kid sick (I say that kindly) , meaning swollen glands, or fever, or repeated bouts of strep. But the kids do not have to have official strep to be candidates for the OR.
- Two other groups: kids who have allergies or problems with lots of antibiotics; kids who have tonsils so huge they cause sleep problems.
My feelings are the same as many docs – these guidelines are just that. Guidelines. Let’s say you have a kid who get three cases of tonsillitis in a year — gets sick as a dog — and misses a bunch of school. Maybe that youngster needs those tonsils gone.
The hope is avoiding surgery may allow a child time to grow out of the tonsillitis phase of life. If your child does need them out, just be thankful the procedure is a lot easier than it was 3,000 years ago.