Why Doctors No Longer Routinely Remove Tonsils-various aspects-
By ENT Specialist – Dr. Sagar Rajkuwar, Nashik, Maharashtra, India
Clinic Website: www.entspecialistinnashik.com
Table of contents-
- Introduction
- Better Understanding of Tonsil Function
- Decline in Infectious Disease Burden
- Shift in Medical Guidelines
- Risks and Complications of Surgery
- Role of Alternative Treatments
- Public Health and Parental Awareness
- Overuse Concerns in the Past
- Special Cases Where Tonsillectomy Is Still Needed
- Conclusion
Introduction
In the mid-20th century, tonsillectomy (surgical removal of the tonsils) was one of the most frequently performed surgeries in children. For decades, it was considered almost a standard procedure for recurrent sore throats, enlarged tonsils, or even as a preventive measure. However, medical practices have shifted significantly, and today, tonsil removal is far less common. Instead of being a routine operation, it is now reserved for carefully selected cases.
The main reasons doctors no longer remove tonsils as often include advances in medical understanding, recognition of the tonsils’ role in immunity, improved treatments for infections, changes in surgical guidelines, and awareness of potential complications.
1. Better Understanding of Tonsil Function
In the past, tonsils were thought to be mostly “useless” tissue that caused more harm than good. This led to widespread removal in children, often for recurrent sore throats or even mild tonsillitis.
However, modern research has shown that tonsils are part of the immune system. Located at the back of the throat, they are part of the Waldeyer’s ring, which includes adenoids and other lymphoid tissues. Tonsils play a role in:
● Sampling pathogens (bacteria, viruses) entering through the mouth and nose.
● Producing antibodies, especially immunoglobulin A (IgA), which provides mucosal immunity.
● Helping to train the immune system during childhood.
With this improved understanding, doctors now recognize that routine removal of tonsils may unnecessarily weaken a child’s immune defense, especially in early years.
2. Decline in Infectious Disease Burden
In the early 1900s, tonsillectomy was often used to prevent recurrent throat infections that could lead to serious complications, such as rheumatic fever and kidney disease (post-streptococcal glomerulonephritis). At that time, these complications were more common and potentially life-threatening.
Today, due to antibiotics, vaccines, and improved healthcare, such complications are rare. For example:
● Penicillin and other antibiotics effectively treat streptococcal throat infections, reducing the need for surgical intervention.
● Public health measures and better hygiene have lowered the rates of severe complications.
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As a result, removing tonsils to prevent infections is no longer seen as necessary in most cases.
3. Shift in Medical Guidelines
Over the years, surgical guidelines have become much stricter. International organizations such as the American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNS) recommend tonsillectomy only in specific situations, such as:
● Recurrent throat infections: More than 7 episodes in 1 year, 5 per year for 2 consecutive years, or 3 per year for 3 consecutive years.
● Obstructive sleep apnea: Caused by enlarged tonsils blocking the airway.
● Complications of tonsillitis, such as peritonsillar abscess (quinsy) that recurs.
● Suspicion of cancer or abnormal growth of tonsil tissue.
This stricter approach means many children and adults who would once have had their tonsils removed are now managed with conservative treatment instead.
4. Risks and Complications of Surgery
Though generally safe, tonsillectomy is not without risks. Doctors have become more cautious due to potential complications, especially in children. Risks include:
● Postoperative bleeding: The most serious risk, which can be life-threatening in rare cases.
● Severe pain: Lasting 1–2 weeks, making it difficult for children to eat or drink.
● Dehydration and weight loss: Due to painful swallowing.
● Anesthetic risks: While rare, general anesthesia always carries some risk.
● Infections: Though the tonsils are removed, the wound itself can occasionally get infected.
Since many sore throats resolve on their own or respond well to antibiotics, doctors often weigh these risks against the potential benefits and decide against surgery unless absolutely necessary.
5. Role of Alternative Treatments
With improved medical care, many of the conditions once treated by tonsillectomy can now be managed without surgery. For example:
● Antibiotics treat bacterial infections.
● Pain relievers and supportive care help manage viral sore throats.
● Allergy management (e.g., antihistamines, nasal sprays) reduces chronic throat irritation.
● Continuous positive airway pressure (CPAP) and other therapies can sometimes help mild cases of sleep apnea.
DISCLAIMER-Some patients go to net and directly take treatment from there which can lead to catastrophic consequences-Then- Many people ask then why to read all this text -the reason is that it helps you to understand the pathology better ,you can cooperate with treatment better ,your treating physician is already busy with his patients and he does not have sufficient time to explain you all the things right from ABCD ,so it is always better to have some knowledge of the disease /disorder you are suffering from.
This availability of alternatives has reduced the need for immediate surgical removal.
6. Public Health and Parental Awareness
Modern parents are more informed about medical procedures and often ask doctors whether surgery is truly necessary. Since tonsillectomy is now known to carry risks, parents may prefer conservative treatments first. Doctors also explain that most children “outgrow” tonsil problems as their immune system matures and tonsils shrink naturally in adolescence.
7. Overuse Concerns in the Past
Historical data shows that in the 1950s and 1960s, tonsillectomy was sometimes performed excessively, even for mild sore throats or as a preventive measure. Many adults today recall that “everyone in the neighborhood had their tonsils out.”
This trend has since been reevaluated. Studies revealed that many of those surgeries were unnecessary and did not significantly improve long-term health. As a result, medical practice shifted to a more evidence-based approach.
8. Special Cases Where Tonsillectomy Is Still Needed
While not routine anymore, tonsillectomy still has an important role in certain conditions:
● Children with sleep-disordered breathing caused by very large tonsils.
● Recurrent strep throat not responding to medical treatment.
● Abscesses or suspected malignancy.
In such cases, the benefits outweigh the risks, and surgery is recommended. But these situations are much less common than the general sore throat complaints that once led to surgery.
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Conclusion
Doctors no longer remove tonsils as routinely as they once did because medical understanding has advanced. We now know that tonsils are an important part of the immune system, that many infections can be managed effectively with medicine, and that surgery carries real risks. Modern guidelines emphasize conservative management first, reserving tonsillectomy for patients with severe, recurrent infections or airway obstruction.
This shift reflects the broader movement in medicine toward evidence-based care, patient safety, and minimizing unnecessary surgical interventions. Tonsillectomy remains a valuable procedure—but only when it is truly needed.
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-FOR INFORMATION IN GREAT DETAIL Severe Headache After Adenoidectomy: Normal or Dangerous? PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Is Adenoid Removal Really Risky? What Every Parent Should Know! PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Does Removing Adenoids Improve Hearing? ENT Expert Explains PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Do You Get Sick More Without Adenoids? The Truth by ENT Specialist PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Can Adenoids Cause Ear Pain? ENT Explains Causes, Symptoms & Treatment PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Adenoids Removed but Still Snoring? Here’s What Might Be Going On PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL “Can You Have Enlarged Adenoids Without Enlarged Tonsils? Hidden Causes of Breathing Problems Explained” PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL How Doctors Check Adenoids: Inside the ENT Process Explained Clearly PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL At What Age Are Adenoids Most Active? Every Parent Should Know This! PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Do Adults Have Adenoids? Shocking Truth You Need to Know! PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Is Adenoid Removal Safe in the Long Run? Here’s What You Should Know PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Can Adenoids Grow Back in Adults? The Truth You Need to Know PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL How Long Does It Take For Adenoids To Grow Back After Surgery PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL “How Much Does an Adenoid X-Ray Cost? Complete Guide to Prices, Insurance & Tests” PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Is Adenoid Surgery Covered by Insurance? Here’s the Truth You Must Know PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Cefuroxime and Adenoid Infections: Effective or Not? PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Can Adenoids Cause Low Oxygen Levels? ENT Explains PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Can Enlarged Adenoids Cause Hearing Loss? PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Does Adenoid Removal Really Cause Weight Gain? The Truth Parents Must Know PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Adenoids and Asthma: Hidden Link Every Parent Must Know PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL How Many People Have Died from Adenoidectomy? The Truth Parents Must Know PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL When Are the Worst Days After Tonsillectomy and Adenoidectomy? Doctor’s Guide PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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-FOR INFORMATION IN GREAT DETAIL Foods to avoid for adenoids PL CLICK ON THE LINK GIVEN BELOW-It is always better to view links from laptop/desktop rather than mobile phone as they may not be seen from mobile phone. ,in case of technical difficulties you need to copy paste this link in google search. In case if you are viewing this blog from mobile phone you need to click on the three dots on the right upper corner of your mobile screen and ENABLE DESKTOP VERSION-
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