Why are tonsillectomies rarely done any more?

[raccoon]

I'm 50-something, and most everybody I knew as a kid had their tonsils out, and so did my mother and most of her generation that I knew.

Sometime in the 70's or 80's maybe, doctors stopped doing tonsillectomies, except in rare cases.

Any DU'ers out there in the medical field know why?

[Hawkeye-X]

1. antibiotics, maybe?

[pitohui]

25. we had antibiotics in the 60s

trust me on this

[SacredCow]

2. Because they're usually not necessary...

I'm 35 and had mine removed when I was about 12 (in contrast to most of my friends) because I was suffering bout after bout of tonsillitus (spelling?). As I understand it, in most people they're a first line of defense against infections. But in some (like me) they can become a constant source of sickness.

On edit... It most definitely did me a world of good. Before having them removed, I was sick with throat issues many times per year. Since then, only once or twice per year if at all.

[sweetheart]

11. unnecessary

They do say that about things they cut off; i had mine out younger
as it was causing hearing loss or at least that's why my parents
figured i was not listening to them. ;-) Perhaps it was the brain
that ruled the tonsils, but better to blame a coupla shrimp.

[Yollam]

19. I was like that too.

The last time, they got so swollen I had trouble breathing, so I asked them to remove them. I believe they usually leave some tissue behind, by the way. At any rate, I'm also glad I got them out. I have had much less in the way of throat problems in the 15 years since.

[Warpy]

3. Because they were counterproductive in most cases

Tonsillitis meant the little buggers were doing their jobs, trapping infection and dealing with it before it got farther down in the respiratory system.

One of the best things my mother did was let me keep mine.

It was a great income generator, though, and replaced by the myringotomy some time in the late 70s/early 80s. That one has largely disappeared, too.

[WiseButAngrySara]

9. So far, this is the most accurate post. Lymphoid hyperplasia in an infant

or a child is healthy and normal. The thymus, tonsils and the appendix are all lymphoid tissues, that help in the production of antibodies and the prevention of the formation of auto-antibodies, amoung other things. Now, with the widespread use of antibiotics for the common cold or ear infections (the majority of which are caused by viruses, and thus not treated with antibiotics which only attack bacteria), there is an epidemic of antibiotic-resistent common bugs in children! This is iatrogenic: caused by physicians and the treatment!

[Avalux]

4. No necessary any longer (probably never was)

Tomsillectomies were performed on children with recurrent tonsillitus (throat) infections (sometimes strep) because they are essentially reservoirs for bacteria. Through effective antibiotic therapy these days, the likelihood of recurrent strep has decreased. Also, studies done on people who have had tonsillectomies show an initial drop in infections, but long term, doesn't seem to make a difference whether the tonsils are there or not.

Standard practice now is to allow tonsillitus to resolve on it's own.

[noonwitch]

5. I'm 41 and still have mine

I only got tonsilitis a couple of times as a kid, so there was no reason to remove them. My sister had tonsilitis multiple times every year-the doctor said one year if she had it again, he was going to take them out. She didn't get it again that year.


Our doctor was conservative about it. I think that more doctors nowdays share that philosophy-why do surgery and remove something if it isn't a serious problem? Especially when most kids grow out of it, and antibiotics clear it up usually pretty quickly.

[Grown2Hate]

6. I'm not in the medical field, but my girlfriend recently had her tonsils..

...taken out. They didn't seem to treat it as a rare case either. They just did it because she was getting strep throat (or at least severe sore throats) 3 or 4 times a year. As I say this, however, I realize she is the only person I know that has had the procedure. Maybe individuals lacking health care/insurance? Another possibility.

[catabryna]

7. My son's ENT had guidelines...

4-6 cases of strep a year were required before he would do a tonsillectomy and he required an extra-strong antibiotic (Rifampin) as a final treatment before he would yank 'em. The Rifampin got rid of the strep for about a week and it came back... so out those tonsils came.

[Fridays Child]

8. Had mine out at the age of two. They grew back, though.

nt

[ayeshahaqqiqa]

10. I'm 55 and still have my tonsils

despite a bout of tonsillities that nearly killed me (105 fever for three days, unconscious the whole time). Specialist said that my tonsils should stay in as they filtered germs-I had the impression they were the first line of defense and that without them I'd get something worse. Specialist took me OFF the antibiotics that had been prescribed by my pediatrician because he said they didn't work, iced me down and said I'd live or die. Interstingly enough, I never got tonsilitis again, whereas before then I got it regularly.

[dflprincess]

15. I'm 52 and still have mine

but my brother lost his. When I first saw the internist I go to now, he looked in my throat and was shocked to find my tonsils. He says he rarely sees them in someone "your age".

[DoYouEverWonder]

12. I had real serious problems with mine when I was a kid

They got so big I could only eat soft and food cut very, very small. At night, I would choke on them hitting the back of my throat. Taking them out made a big difference. Has an adult, I rarely get sick even when everyone else is sick around me, so at least I still have a decent immune system at this point.

[SacredCow]

14. Oh, yeah- I forgot about that part...

Mine became freakishly large, too, which also contributed to the decision to remove them. I can't say that I've ever missed them!

[jayfish]

21. My Son Had A Very Similar Problem As You.

His tonsils were so big that he would store his food in his cheeks because he couldn't swallow. He had to have them out at thirteen-months old. He was the youngest tonsillectomy patient the hospital had ever had. He hasn't been sick since. I also had horrendous difficulty with my tonsils. I would get tonsillitis multiple times a year. The fevers that accompanied it were so bad they caused hallucinations. I also was very susceptible to the flu. I had mine removed when I was a sophomore in high-school and can count' the number of times I have been truly (wink-wink) since on one hand and I haven't had a sore throat since. Tonsillectomies have been good for me. ...so far.


Jay

EDITED FOR CONTENT

[Solon]

29. In my case, it was similar...

My Mom went to wake me up when I was about 8 years old for school, and my lips were turning blue, and my breathe was almost non-existent. Only ride I ever took in an Ambulance, wish I remembered it. Next thing I knew, I'm in a hospital room, with Grandma, Grandpa, Mom and Dad there, plus my Aunts and Uncles showed up later that day. I remember a pain in my hand from the damned IV, and everybody trying to keep me calm(no problem, I was STILL tired). Anyways, then a nurse came in, gave me a chocolate cookie for moving on my own to a gurney. This kinda sucked because I HATED the texture of cookies, at the time my taste buds were inoperative and my tongue was abnormally short.

So, I get wheeled into the operating room, saw 3 lights above me, and soon enough, out like a light. Afterwards, I remember having to spend a week or two gradually building back up to solid food. This was OK, because I could TASTE the stuff, the pudding, ice cream, even the milk was excellent. My tongue hurt during this time though, so I had to be careful, they cut it underneath so I could "stick out my tongue" and speak properly. Its was a complicated procedure.

[AngryAmish]

13. A friend of mine is getting his out in a few weeks

Sleep apnea.

[emcguffie]

16. My daughter's were taken out when she was nine, --

for sleep apnea. She gained 10 pounds in a month.

Mine were taken out when I was 20, but I wish I had them back. My father was an MD, and he was against it. I had my appendix out about 10 years ago, and came down with CFS. Seems both organs are upfront in the immune system, and CFS is definitely involved with the immune system.

I may have had CFS for a long time, it seems to come in layers, but the worst layer definitely came after the appendix came out.

I think when I had my tonsils out I was probably suffering from mononucleosis on top of recurring strep, but just never, ever got well. After the tonsils came out, I did seem to get well, for a while anyway. Give me my tonsils back!

[raccoon]

20. I gained weight after I had mine out, too. I was ten. nt

[emcguffie]

23. Did you have sleep apnea?

My daughter did. I had to fight with my husband for years to have hers out. But she had sleep apnea, had had it always, and she was so teensy weensy.

She struggled for every breath when she was asleep. I have sleep apnea, and I sleep with CPAP. Since I was going to see a sleep doctor, I mentioned that my daughter had it, and the doctor just went nuts, said I had to do something about it SOON, by the time she was 8 or 9, or she would end up needing CPAP too. Something about the pressure of the tongue on the palate causing the face and the nasal passages to malform, making breathing even harder.

So I did have them out. But as I said I had to fight with my husband for years first.

And that first month, those ten pounds -- what a difference! It was just incredible. Her little legs had not ever filled up the legholes in underwear, you know? She was 8 years old and wearing a size four, and it was baggy. No more.

I guess there are times they should come out, but it's better if you can keep them.

Looking back, it might have been better to make her sleep with CPAP while she was little, and have her facial structure develop correctly, but leave the tonsils in. I don't know.

[raccoon]

28. No, just got cold and sore throats a lot. nt

[DrBloodmoney]

17. Still done all the time.

Sorry I'm a pathologist. I gross in the surgical specimens. I probably gross 5 to 6 a day (major medical center).

[Sgent]

22. Ask some older ENT's

how often they do them, then ask the younger ones.

Its still not an infrequent surgery -- but it is not done nearly as frequently. 30 years ago, it was done almost as often as ear tubes and/or wisdom teeth removal.

[Buck Laser]

18. My grandson had his out last winter...

and it seemed to pretty well end the endless strep infections he was suffering. He's seven, and hasn't had a sick day since. The other four grandkids still have their tonsils, but no particular problems with infections. My kids, in their 40s, still have their tonsils, but I know of no one my age (71) who still has tonsils. So I'd guess the operation is far less common, but still useful in some instances.

[pitohui]

24. they were a scam

they were a revenue source for doctors and hospitals

me and my sibs got none in the 60s, why, because my parents had an unpaid doctor's bill at the hospital where i was born which was in dispute for years

every other kid we knew got their tonsils out

it was pretty clear to me even as a kid this couldn't be a health issue but rather a fund-raising effort by the doctors -- and as our family was known to be a possible non payer our tonsils were in magically good health

[Mandate My Ass]

26. 45 and still have mine despite recurrent strep and tonsillitis

as a child. Both my older brothers had theirs out very young but because I have a heart murmur, they left mine in. They said if they remove the tonsils, the bad valve will become my weakest line of defense for bacteria. Better to have tonsillitis than heart valve replacement surgery. I have very few problems with my throat anymore though.

[Lars39]

27. That's interesting!

I had my tonsils out *because* of recurrent strep throat that led to rheumatic fever that caused a heart murmur. I 'outgrew' my heart murmur, though.

[bobbieinok]

30. my brothers and I are over 60.....we all had out tonsils out when we

were quite young......I do not remember that any of us had any medical conditions requiring it, altho one brother had asthma....he was the first to have them out; doctors may have thought that was some indication that we might all have problems later