Routine tonsillectomies are thing of the past

DEAR DR. ROACH

» I am a 72-yearold woman who is blessed with good health. In my adolescent years, I occasionally got strep throat, but a respected doctor of internal medicine (later head of a medical school) cautioned my mother against ever having my tonsils taken out. The general advice of the day was to have them removed, but he said that the tonsils are the first line of defense against more serious infections — that they serve to filter out bad microbes that invade the body and a mild sore throat can be proof that the tonsils are doing their job.

I wonder, when doctors or researchers are putting together their questionnaires to attempt to determine why one person has certain symptoms of a disease but not others, or why certain people are more vulnerable to an infectious disease when others aren’t, is the question ever asked if patients still have their tonsils? It strikes me as a simple question that could possibly lead to a deeper analysis of the body’s defense mechanisms.

— S. J.W.

Removing the adenoids (typically done at the same time) increased the risk of developing chronic obstructive lung disease.

DEAR READER » Long-term followup of children who have had their tonsils removed shows approximately double the risk of developing respiratory infections in the subsequent 10-30 years. Removing the adenoids (typically done at the same time) increased the risk of developing chronic obstructive lung disease.

As you note, far fewer of today’s children have their tonsils out compared with the almost routine tonsillectomy of years ago. I agree with you that more research is called for. However, I will note that during an exam, lack of tonsils and adenoids is usually quite apparent, and enlarged tonsils certainly are.