Cut or keep? This is indeed a question. Many parents of children with tonsil removal say with one voice that the immunity will be greatly reduced after tonsil removal, including many professional doctors also think so, so it is highly recommended not to remove tonsils before 8 years old. In fact, this is a big misconception. This aspect is discussed below to see what scientific studies actually say about this issue. First, the following are absolute indications for tonsil surgery: 1. Recurrent acute suppurative tonsillitis that may or has affected adjacent organs or distant organs, such as the heart, kidneys, and joints. 2, Hypertrophic tonsils and adenoids seriously affect the breathing, swallowing and growth of children, such as severe snoring during sleep, etc. 3.Peritonsillar abscess, even in the attack period, should be performed tonsillectomy, while abscess drainage can be achieved. 4. Benign tumors of tonsils and tonsillar keratosis should be promptly removed from the tonsils. So, as an ENT doctor, why do you want to remove tonsils? There must be one or more of the above cases, these cases tonsils, adenoids are not only no longer useful, but also very harmful, so most of us will discuss whether to remove the tonsils only in this case, there will not be any responsible doctor will arbitrarily let you remove the tonsils, so dogmatic that a few years old should not be removed, or overemphasize the immune function of the tonsils, glands is a big It is a big misconception. In fact, every otolaryngologist is of the opinion that “if you can do it, don’t do it, and if you can do it later, do it later, but if you have to do it, do it as soon as possible”. Secondly, is it true that the immune function of children decreases after removal of tonsils and adenoids? Since the 1990s, a large number of foreign and domestic clinical basic studies have shown that there is no significant difference between the immune function in the near and long term after removal of tonsils, while for children with long-term recurrent tonsillitis, the immune index is enhanced after removal. Too much foreign literature has pointed out that children show a significant decrease in IgA, IgG, and IgM within 1 month after surgery; in other words, the immune function decreases at this time. However, after 2 months postoperatively, IgA first rebounded and gradually returned to preoperative levels. At 6 months after surgery IgG and IgM also gradually recovered. In other words, 2 months after surgery, the immune function declined and reached the bottom, and then gradually rebounded and reached the preoperative level by 6 months after surgery. Many scholars in China have also studied the “long-term changes of immune function from childhood to adulthood after removal of tonsils and adenoids”, and concluded that except for the enlargement of the pharyngeal cavity and a slight increase in the incidence of pharyngitis after tonsil removal, there is no difference between the immune indexes and the control group (i.e. normal people). This indicates that the removal of tonsils and adenoids has no significant effect on the immunity of human beings in the future. It was further found that in children with recurrent acute tonsillitis, timely removal of tonsils resulted in a significant increase in the immune indexes compared with those before surgery, indicating the necessity of timely removal under certain circumstances. We have already come to the conclusion that the removal of tonsils and adenoids has little effect on the immune function of children, what is the reason for this? In fact, there are many lymphatic organs in the human pharynx, including tonsils, adenoids, pharyngeal lateral cords, tongue root tonsils, pharyngeal lymphatic follicles, pharyngeal bullae tonsils, etc. They are arranged in a circular pattern in the pharynx – called the inner ring, in addition to the lymphatic outer ring, all are immune organs of the human body, tonsils and adenoids are only two of these organs, after removal, other lymphatic organs will rapidly compensate for the loss of these The human body is adaptable, so the change in immune function after removal of the tonsils is not significant. To summarize my personal opinion, normal or physiologically enlarged tonsils and adenoids do not need to be removed, which does not need to be discussed; while tonsil abscesses, benign tonsil tumors, and tonsil keratosis must be removed as soon as possible, which also does not need to be hesitated. For pathological hypertrophy of tonsils or focal tonsils, conservative treatment should be considered first, but if it is ineffective, timely surgery should be considered, and this common childhood disease cannot and should not be treated as a cured disease.