Immunological basis of indications for tonsillectomy and adenoidectomy.

The tonsils are immune organs. The necessity for T & A should have a more rational approach for selected cases. The tonsils have a large immune function. The defense function of the tonsils is much greater in children than in adults. The children develop their resistance to infection by the time they are 7-8 years old. Tonsils and adenoids should not be removed below the age of eight unless there are absolute indications. Tonsillectomy has little or no effect on allergy. It is being done on account of tonsillar sepsis, and no other results are to be expected. In cases of obstructive tonsillar hypertrophy in young children, unilateral tonsillectomy is indicated. T & A are two separate operations, each with their own indications. Tonsillar focality could be regarded as a qualitative alteration in tonsillar antibody formation. The treatment of recurrent tonsillitis is related to the age of the patient. The solution to the problem up to an age of about 12 is quite different from that in older people. Alternatives to surgery are immunotherapy, intermittent chemotherapy and observation.