Should pediatric tonsils be cut out?
We first need to know what the tonsils are. The human pharynx is rich in lymphatic tissue, of which the tonsils are gathered into a mass, including the largest pair of palatine tonsils, pharyngeal tonsils, tongue tonsils, pharyngeal tonsils, etc. The palatine tonsils are what we often call tonsils.
The surface of the tonsils has 10-20 sockets in the deep part of the tonsils, where there are usually a lot of bacteria, but usually the tonsils are not inflamed, but only when overworked, cold, and the body’s resistance is reduced, the bacteria in them multiply, and the pathogenic bacteria make the tonsils red, inflamed, and purulent, causing sore throat and fever in the affected children.
The tonsils themselves are an important immune organ that can defend the body against invasion of various disease-causing microorganisms and play an anti-disease role, especially in children until the age of 4. The strong immune function is an important physiological anti-disease defense for children. However, some children have frequent inflammation of the tonsils, which can cause them to lose their normal function and become harmful “foci”, and some can also cause lesions in other organs of the body, such as nephritis, rheumatoid arthritis, rheumatic heart disease, myocarditis, etc.
Tonsillitis is divided into acute and chronic
Acute inflammation is treated with antibiotics and local symptomatic treatment, which can be cured in about 7 to 10 days.
The most common cause of chronic tonsillitis is the recurrence of acute inflammation or local inflammation that does not heal. Some children often have recurrent tonsillitis, 4-5 times a year, or even once a month in some children, or the next time they are inflamed after being cured for a couple of days.
Tonsil inflammation has a great impact on the child, often making the child very poor health, low resistance, a change in the weather or fatigue will be inflamed, thus forming a vicious circle. Such tonsils are harmful and unhelpful to the body. Inflammation of the nose and throat can also cause inflammation of the tonsils.
What kind of tonsils need to be removed?
(1) Frequent attacks of tonsillitis, 4 to 5 times a year or more, inflammation with systemic symptoms, high fever, sore throat, enlarged tonsils, congestion, pus spots on the surface and enlarged submandibular lymph nodes.
(2) There has been peri-tonsillitis or peri-tonsillar abscess.
(3) Enlarged tonsils that have interfered with sleeping, breathing, and eating in children. The enlarged tonsils block the pharynx of the child, resulting in difficulty in swallowing and slow eating during meals, coarse outgassing of the child in general, wheezing during activities, open-mouth breathing and snoring during sleep, and sometimes apnea, when the tonsils will affect the growth and development of the child and should be removed.
(4) Focal tonsils, tonsils are often inflamed causing or complicating nephritis, rheumatic heart disease, arthritis, myocarditis, etc. Now research has found that the onset of psoriasis is related to tonsillitis, such patients can consider removal of tonsils during the period of stable disease.
(5) Long-term unexplained low fever, while the tonsils themselves have chronic inflammation, if other diseases are ruled out the tonsils can be removed.
(6) Other conditions of the tonsils such as stones, keratosis, polyps, cysts or other benign tumors.
(7) Malignant tumors of the tonsils can be removed in the early stage without metastasis, and the removal can be supplemented with radiation and chemotherapy.
Under what circumstances is surgery inappropriate?
(1) When the tonsils are inflamed, the operation is prone to secondary infection or bleeding during the operation, and the wound is prone to bleeding after the operation, so it is better to control the inflammation before the operation.
(2) Girls should not undergo surgery, including other surgeries, during menstruation or premenstruation, because the surgery is likely to bleed a lot at this time.
(3) If you have hematopoietic or coagulation system diseases, such as leukemia, aplastic anemia, purpura, etc.
(4) Surgery is not recommended when nephritis, hepatitis, rheumatism and tuberculosis are not controlled.
Parents should listen to the advice of the ear, nose and throat doctor and consider carefully, not blindly, whether to operate on the tonsils or not. Although tonsillectomy is a minor surgery, surgery is always a risk.