When it comes to the tonsils, we know them as the small, round, slightly peach-colored, protruding things on either side of the throat. You may be able to see it when you flatten your tongue and say “ah” or yawn. We often hear the term “tonsillitis”, especially in the cold winter months, when the small tonsils can cause us a lot of pain if we are not careful. The tonsils are a bit like a sponge, with many tiny holes and cracks. When attacked by bacteria and other microorganisms, it becomes inflamed, red and swollen. As a result, it can lead to tonsillitis or other painful diseases such as otitis media and sinusitis. And this troublesome little thing can sometimes cause snoring, waking up easily in bed, or other adverse reactions. Many people want to have their tonsils removed as soon as a child’s throat becomes inflamed because they don’t know enough about the function of the tonsils and are considered to be like the appendix, an organ in the body that serves no purpose. However, recent studies have shown that the tonsils contain lymphoid tissue, plasma cells and T and B cells involved in cellular immunity; they can produce various immunoglobulins and special antibodies; and they can also secrete interferon, which inhibits the growth of bacteria. Therefore, it is an important defense organ of the body and participates in the body’s immune function network. Its immunity is most active in children between 3 and 5 years old, so it is prudent to remove the tonsils in children under 5 years old. In terms of immune theory, the tonsils are indeed useful as a “natural barrier” to the body, the “first line of defense” against respiratory diseases. But once this line of defense is breached, it in turn brings many hazards to the body. If there is a serious infection in the tonsils, such as when a child has a cold or fever, the tonsils become inflamed, and if they are often repeatedly inflamed, it will prevent toxins from being discharged from the tonsils, which can easily become a “lesion”. This can cause many systemic diseases, such as rheumatic fever, glomerulonephritis, rheumatic heart disease, rheumatoid arthritis, asthma and other diseases. In addition, too much hypertrophy can also make the child speak with a heavy nasal voice, which can also easily cause middle ear infections such as sinusitis. At this point, the tonsils are not only unhealthy, but also bring more pain to the body, so tonsillectomy should be performed. Generally speaking, physiological enlargement of the tonsils in childhood is normal, but when it affects breathing, swallowing and pronunciation, the tonsils should be surgically removed. So when do you need surgery? If chronic tonsillitis recurs frequently, more than 4 to 5 times in a year; or if there has been peri-tonsillitis and peri-abscess; when excessive enlargement of the tonsils has affected breathing and sleep; when there is complication of tonsillitis with nephritis, rheumatic heart disease, myocarditis and rheumatoid arthritis; when tonsillar keratosis or tonsillar polypoid hyperplasia, cysts and other benign masses occur, they can be removed . Therefore, we can know that whether tonsils are useful and need to be removed or not needs to be judged on a case-by-case basis.