Tonsillectomy

Overview

Tonsillectomy is the surgical removal of tonsils. It is one of the most common surgeries for children in the U.S., with about 289,000 done each year. It reduces throat infections and make breathing easier. Tonsillectomy is only helpful for patients who meet certain criteria, but for others with mild problems, the risks and costs outweigh the benefits. 

Understanding Your Condition

Tonsils are soft lumps at the back of the throat. They protect your body from microbes that come in through your mouth or nose. 

When tonsils become swollen or infected too often, they stop working properly. This can lead to more frequent illness, poor sleep, and missed school or work. 

Candidates

Sore throat alone doesn't mean you need to remove your tonsils. 1Mitchell, R. B., Archer, S. M., Ishman, S. L., Rosenfeld, R. M., Coles, S., Finestone, S. A., Friedman, N. R., Giordano, T., Hildrew, D. M., Kim, T. W., Lloyd, R. M., Parikh, S. R., Shulman, S. T., Walner, D. L., Walsh, S. A., & Nnacheta, L. C. (2019). Clinical Practice Guideline: Tonsillectomy in Children (Update). Otolaryngology–Head and Neck Surgery, 160(S1). https://doi.org/10.1177/0194599818801757 We recommend tonsillectomy only when your throat infections meet any of the following criteria: 

• 7 or more throat infections in the prior year 
• 5 or more per year for the past 2 years. 
• 3 or more per year for the past 3 years.

Tonsillectomy is only done if your sore throats are from bacteria. To confirm it is bacteria, you should have:  

• Body temperature >38.5 C  
• Whitish patches or pus on your tonsils 
• Positive bacterial lab test

Benefits

Fewer and milder throat infections  

Improved Breathing:  60-80% cure rate , 12% reduction of symptom progression. 2Camacho, M., Li, D., Kawai, M., Zaghi, S., Teixeira, J., Senchak, A. J., Brietzke, S. E., Frasier, S., & Certal, V. (2016). Tonsillectomy for adult obstructive sleep apnea: A systematic review and meta-analysis: Adult Tonsillectomy for OSA. The Laryngoscope, 126(9), 2176–2186. https://doi.org/10.1002/lary.25931 3Lam, D. J. (2025). The Butterfly Effect of Adenotonsillectomy. JAMA Otolaryngology–Head & Neck Surgery, 151(5), 431. https://doi.org/10.1001/jamaoto.2025.0117

Better sleep quality: since it relieves airway obstruction caused by enlarged tonsils.  

Fewer missed days from school or work. 4Bhattacharyya, N., Kepnes, L. J., & Shapiro, J. (2001). Efficacy and Quality-of-Life Impact of Adult Tonsillectomy. Archives of Otolaryngology–Head & Neck Surgery, 127(11), 1347. https://doi.org/10.1001/archotol.127.11.1347 5Wilson, J. A., Fouweather, T., Stocken, D. D., Homer, T., Haighton, C., Rousseau, N., O’Hara, J., Vale, L., Wilson, R., Carnell, S., Wilkes, S., Morrison, J., Ah-See, K., Carrie, S., Hopkins, C., Howe, N., Hussain, M., Lindley, L., MacKenzie, K., … Teare, D. (2023). Tonsillectomy compared with conservative management in patients over 16 years with recurrent sore throat: The NATTINA RCT and economic evaluation. Health Technology Assessment, 1–195. https://doi.org/10.3310/YKUR3660

Common Misconceptions

Adults shouldn’t undergo tonsillectomy 

There is no age limit for tonsillectomy. While tonsil infection is more common in children, adults can undergo tonsillectomy if they follow any of the previously mentioned criteria.  

Some adults worry that surgery is too risky at their age. In reality, the main difference is that recovery often takes longer. Otherwise, tonsillectomy is generally safe for adults, with risks similar to children.  

Once the Tonsils are Removed, You’ll Never Get a Sore Throat again  

Not every sore throat is caused by a tonsil infection. Tonsillectomy reduces the number of sore throats caused by tonsil infection, but it doesn’t affect sore throat from other throat structures. 

You can eat unlimited ice cream after tonsillectomy 

Eating a lot of ice cream or exposing your throat to cold temperatures will not magically be risk-free after tonsillectomy. While the surgery will reduce the frequency of severe sore throats, consuming very cold foods in excess could still irritate your throat or cause discomfort. 

Removing Tonsils Will Weaken the Immune System 

Besides tonsils, your body has multiple ways to fight microbes. Your immunity can transiently drop after surgery, but no sufficient proof suggests that tonsil removal causes a long-term risk of allergies or infections.  

While some research studies suggest a link, it’s not clear if the surgery is the cause, since these conditions are common even in people who haven't had the surgery

Procedure Types