Childhood is full of little medical rites of passage. Every kid eventually catches a nasty ear infection or a bad case of strep throat. Before the release of its vaccine, adults of a certain age remember catching chicken pox and missing a week of school to stay home and resist the urge to scratch. But perhaps most iconic are the doctor’s orders to sit on the couch and eat Jell-O and ice cream—the fun side of having one’s tonsils removed.
Nevertheless, some people make it through childhood without the need for a tonsillectomy and that post-operative ice cream. But that doesn’t mean you’re out of the woods. Your tonsils—the hardworking first rank of your immune system—can still pose problems after childhood, necessitating surgical removal. Here are some of the reasons an adult may need their tonsils removed—though you may not exactly feel like a kid again.
Frequent Bacterial Tonsillitis
Understanding tonsillitis begins with understanding what the tonsils do. Intact tonsils serve the immune system by intercepting and reacting to pathogens you inhale, initiating a rapid response to infectious agents. However, just like all wars have casualties, tonsils are often casualties of so many pathogens. In the process of capturing bacteria that would otherwise infect you, the tonsils can become infected themselves. The subsequent inflammation of the tonsils causes pain and bad breath, and it can even block the airway. It doesn’t take many cases of tonsillitis for doctors and parents to elect to remove a child’s tonsils, but in adulthood, ten cases of tonsillitis in two years or seven cases in one is a good rule of thumb to pursue adult tonsillectomy.
The second reason most children have their tonsils removed is sleep apnea, or the interruption of breathing during sleep. Usually, this is the result of tonsils that are too big for the throat, which causes harmful obstruction. Some children don’t experience these too-large tonsils, so doctors will decide to leave the tonsils in place. But sleep apnea can reveal itself at any age, just as the allergies that cause tonsil inflammation can. If adult-onset sleep apnea involving enlarged tonsils is an issue that other allergy treatments cannot address, your doctor may recommend a tonsillectomy to open the airway. Allergy ENT & Associates, a leading Houston allergist, may be able to help.
Cancer of the tonsils is rare due to the sheer number of juvenile tonsillectomies obviating the possibility, but in people who retain their tonsils, benign or even malignant growths can occur in the tonsils. Tonsil cancer has been linked to the human papilloma virus, or HPV. In this case, a tonsillectomy is necessary to stop the spread of cancerous tissue throughout the throat and related areas. Though not a common cause, it represents the most urgent reason an adult may need their tonsils removed.