What most people refer to as “tonsils” are known as Palatine tonsils.
These are the two large protruding tissues that reside on the sides of the back of your
throat.
These are actually part of a grouping of lymphoid tissues (tissue that perform different functions
for your immune system) known as Waldeyer’s tonsillar ring.
Waldeyer’s ring creates a rough circular edge at the opening of our digestive system.
Encompassing both the nasopharynx (the space where your nose meets the back of your throat)
and the oropharynx (the back of your throat), it creates a barrier of sorts.
It’s the first point of contact our immune system has with the bacteria and microbes
we ingest or inhale.
While the Palatine tonsils are the largest part of Waldeyer’s ring, the other parts
include the pharyngeal tonsil, also known as the adenoids, Gerlach’s tonsils, which
are at the opening between your nasopharynx and your middle ear, known as your eustachian
tubes, and the lingual tonsils which are the tissues that resides on the base of your tongue.
Your lymphatic system has many responsibilities that intertwine with each other.
Its main responsibility is to collect and transport fluid from all of the inter-cellular
spaces of the body (known as interstitial fluid), back to the bloodstream.
It’s also responsible for transporting digested fats and large molecules like enzymes and
hormones from the places they are created to the bloodstream.
The other thing the lymphatic system does, in reference to the tonsils, is create antibodies
that help in building an immunity to infectious diseases.
They also help filter out smaller bacterias and toxins.
So to answer your question specifically, the tonsils’ job, in this web of logistical
functions, is to create antibodies (immunoglobulins).
Most active between the ages of 4 and 10, they have been observed creating a type of
lymphocyte (a type of white blood cell) known as a B cell.
There are several different types of theses cells and they are programmed to make specific
antibodies.
One type might make an antibody for bacteria that causes pneumonia, while another might
make an antibody for the common cold.
Once created by the tonsils, these B cells will move to the mucus in your upper airway,
salivary and lacrimal glands.
When it comes in contact with a source that will trigger it, like pneumonia bacteria,
it will trigger larger plasma cells to produce more antibodies.
This evolutionary barrier to bacterial attack seems exceedingly important to me.
So the question still remains, why did at one time everyone born within ear-shot of
a doctor seem to have them removed?
Why has this approach suddenly become less common place?
Short answers: Infections and technological advances in modern medicine.
Long answer…
The biggest reason for removing your tonsils (tonsillectomy) used to be their reoccurring
infection.
This usually occurs between the ages of 4-10 when they are the most active.
By the age of 11, your tonsils will begin to shrink and the chance of them becoming
infected lessens.
One of the main culprits causing your tonsils problems is the streptococcus bacterium (strep
throat), and many people can get numerous tonsil infections, even several per year.
Before the advent of modern antibiotics, removing them from the equation was the best available
treatment for reducing the chance of this painful chronic condition.
The fact that there were relatively low complication rates to a tonsillectomy helped make this
procedure commonplace until recently.
With the introduction of antibiotics, it has now become easier to treat tonsillitis with
antibiotics as opposed to surgery.
Dr. Chris Johnson states, “I first trained and practiced as a pediatric infectious disease
specialist, and I was consulted many times about such children (tonsillitis patients).
My bias was nearly always against tonsillectomy.
My reason, shared by most infectious disease experts, was that we have effective antibiotics
to treat strep.
Why risk the surgery?”
In 2002, Tom Marshall published “The Effectiveness of Tonsillectomies” in the Oxford Journals
“Family Practice”.
In it, he laid out why tonsillectomies are slowly becoming a thing of the past, when
treating recurrent tonsillitis.
In the only controlled trial that demonstrated effectiveness of tonsillectomies, only 25%
of patients who had one performed on them, met the criteria recommended.
In fact, many studies point out there is insufficient evidence, in many cases, to justify the risks
of surgery.
In response to this glaring oversight on many doctors’ parts, he replied “Perhaps the
simplest solution to this problem is to tell patients the truth.
A child who meets these strict criteria will probably suffer from 6 throat infections in
the next two years.
A child who has surgery now will probably suffer from 3 throat infections.
In two years, there will probably be no difference.”
I know what you’re thinking.
Why would you want to remove any tissue that helps fight infection?
The answer is that most people have no increase in the risk of other body infections when
the tonsils are removed.
This is why it’s still a common procedure for afflictions like reoccurring tonsillitis
that does not respond to antibiotics, tonsil abscesses that do no respond to drainage,
too large of tonsils that can affect nighttime breathing, or tumors of
the tonsils.
Tonsils contain pockets on them.
When we eat or drink bacteria, dead cells, mucous, and other materials can become trapped
in them.
Over time, these concentrated debris can become calcified and become what is known as a tonsillolith
or tonsil stone.
Ever wonder what those white chunks are at the back of your throat?
Now you know.
They’re a bit gross, and they smell awful, but in most cases aren’t really
a big deal.