The Function and Location of the Tonsils

Pediatrician checking patients mouth in office
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The tonsils are part of the lymph system of the body, which is part of the immune system. The tonsils help the immune system fight infection but are subject to becoming infected themselves, especially in childhood.

Anatomy of Tonsils

There are three sets of tonsils in the back of the mouth: the adenoids, the palantine, and the lingual tonsils. These tonsils are made up of lymphatic tissue and are typically small in size. These three sets of tonsils help the immune system defend against infections, particularly infections in the throat—such as strep throat

The tonsils that are visible when looking in the mouth are the palantine tonsils. The tonsils grow until puberty, then begins to shrink in the following years.

Why Tonsils Are Removed

While doing their work preventing infection, the tonsils themselves may become recurrently infected and need to be removed, a surgery called a tonsillectomy. A single tonsil infection would usually just be treated with an antibiotic. 

The palantine tonsils are the most obvious (easy to see) when they become infected and inflamed, but all three sets can become enlarged. In serious cases, the tonsils can become the size of a walnut and in rare cases can be so large that breathing is difficult. If breathing is a problem due to the size of the tonsils, or they become infected repeatedly in a short period of time, surgery may be necessary.

Most tonsillectomy procedures are performed in childhood, as most people grow out of tonsil infections as they age. While infection of the tonsils is most common in childhood, they may still need to be removed in adulthood if they are large enough to obstruct the ability to breathe. Adults with sleep apnea may have a tonsillectomy and adenoidectomy as treatment.

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  1. InformedHealth.org. How do the tonsils work? Updated January 17, 2019.

  2. National Library of Medicine. MedlinePlus. Tonsillitis. Updated January 27, 2020.

  3. Reckley LK, Fernandez-salvador C, Camacho M. The effect of tonsillectomy on obstructive sleep apnea: an overview of systematic reviews. Nat Sci Sleep. 2018;10:105-110.