To remove or not to remove tonsils? The debate over whether to remove or not tonsils

There is an organ in our body that has different opinions on. Some people attribute all the pain in the throat to it and want to get rid of it as soon as possible; others list its merits and functions and try their best to protect it.

This organ is the tonsil.

Today, Dr. Shangguan of Maritime Otolaryngology invited representatives from both sides, "The Lancet" and "Tonsil", to participate in the on-site debate, which is recorded below.

The affirmative side "Lancet" said:

Dear judges and readers, hello! We insist that for those who suffer from repeated tonsillitis, the benefits of tonsillectomy outweigh the disadvantages. Although tonsils are part of the immune system, after repeated infections, they may become lesions, which may not heal and may even cause serious complications.

First of all, many friends who have chronic tonsillitis have repeated attacks of the disease, and they often suffer from sore throat and fever, which seriously affects their lives. Removing tonsils can completely eliminate the infected lesions, which is undoubtedly a relief for friends who have suffered from inflammation for a long time. Secondly, repeated infections can cause tonsil enlargement or hyperplasia. Many patients gradually begin to snore, and in severe cases, they will experience sleep apnea. Some children even affect their intellectual development due to holding their breath and lack of oxygen. Furthermore, the pathogens in the lesions can act as self-antigens to produce specific antibodies in the body. After repeated tonsillitis, the antigens and antibodies combine to form immune complexes, which are precipitated in the terminal blood vessels of various organs. It has been confirmed that repeated tonsil infections may further induce serious complications of other organs such as chronic glomerulonephritis. Therefore, we believe that removing tonsils can reduce the risk of these complications and ensure the safety of patients' lives. Why not do it?

The opposing “tonsils” spoke:

Dear judges and readers, hello! Our opinion is that in most cases, it is more reasonable to preserve the tonsils.

First of all, as part of the immune system, our tonsils can produce antibodies and have a certain defensive effect against viruses, bacteria, etc. We are the body's first line of defense and can resist the invasion of external pathogens. Secondly, after tonsillectomy, the patient's immune function may be affected to a certain extent. Although this effect may be temporary, in certain specific cases, such as childhood, retaining tonsils is essential for maintaining overall immune function. At the same time, is there no risk in tonsillectomy? On the contrary, although the operation is not big, the risk is not small. Various complications are prone to occur after tonsillectomy. Pain and dysphagia are common, and wound bleeding again and surgical cavity infection are also common. Finally, for most patients with tonsillitis, it is possible to effectively control and relieve symptoms through drug treatment and lifestyle adjustments. Therefore, we do not recommend removing tonsils easily unless it is necessary.

The affirmative side "Lancet" said:

Please be careful, "tonsils", don't disguise yourself as a little cutie. As we all know, the immune barrier of the human oropharynx is mainly the pharyngeal lymphatic ring (Waldeyer lymphatic ring), which is divided into the inner ring and the outer ring. As a representative of the inner ring, I know you have made great contributions in human childhood, but don't forget that after most people become adults, the immune system of the oropharynx has long been dominated by the outer ring represented by the submandibular lymph nodes. You should have retreated to the second line and gradually atrophied, and even your shadow should not be seen when you open your mouth. But you are so good, not only did you not shrink, but you also proliferated and hypertrophied. You still say everywhere that "tonsils are the first line of defense", but forget it, you should have given way to the "lymph node brothers" in this line of defense. For you, the root of trouble who colludes with bacteria and viruses, does no good, and eats from the inside out, you should be resolutely removed!

The opposing “tonsils” spoke:

Please don't get emotional or make personal attacks, "Lancet" students. I think you only know how to operate without knowing right from wrong, right? First of all, the lesion problem mentioned by "Lancet" students does exist, but you also have to keep up with the times. It is true that many infected lesions did not have good drug treatment options in the past, and they had to be surgically removed. But with the advancement of technology, many advanced antibacterial drugs have achieved good results in the treatment of chronic tonsillitis. We can try conservative treatment first. Secondly, "Lancet" does not distinguish between friends and foes. Our common enemy is the invading pathogenic microorganisms. I also hope to control the infection and restore normalcy.

Comments from judge Dr. Shangguan:

Thank you to both sides for your wonderful speeches.

To remove the tonsils or not is indeed a complex issue that requires comprehensive consideration from multiple angles. The affirmative side explained the necessity of removing the tonsils from the aspects of eliminating lesions, improving breathing, and reducing complications; while the negative side put forward the rationality of not removing the tonsils from the aspects of the importance of retaining the tonsils to immune function and the risks of surgery.

So, I think what both of you said is very good and correct. When you really encounter such a choice in clinical practice, you still need to analyze the specific problem specifically, fully understand the pros and cons of the surgery, and fully discuss your own situation with the doctor before making a decision.

After all, everyone's situation is different.