Get to Know Your Tonsils

There Are 3 Pairs of Tonsils in the Throat

Tonsils are specialized organs that are part of the lymphatic system and provide your body’s first protective barrier from foreign substances that you inhale or ingest through the nose or mouth. Once trapped in the tonsils, bacteria or viruses are then transported to lymph nodes where specialized immune cells cluster to fight infection. However, in some cases, tonsils may become infected and need to be removed through a very common procedure called a tonsillectomy.

Doctor examining girl’s tonsils with tongue depressor in clinic
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Three Pairs of Tonsils in the Throat

There are actually three pairs of tonsils:

  • Pharyngeal tonsils (adenoids), which reside behind your nose
  • Two palatine tonsils (what people are most commonly referring to when they say the word 'tonsils'), which reside on both sides of the back of the throat
  • Lingual tonsils, which are at the back of the tongue

A bit contrary to their function, the tonsils can become infected. When examining your tonsils, a physician will usually use your medical history, a physical exam, and in some cases an X-ray (to further examine the adenoids) or blood tests (to determine whether mononucleosis is the cause of tonsil enlargement). Tonsil enlargement is not always considered a problem. However, individuals with enlarged tonsils should be evaluated for the following possible problems related to enlarged tonsils:


The tonsils can be surgically removed if necessary. This is called a tonsillectomy. There are two types of tonsillectomies: complete removal and partial removal.

At one point, physicians removed tonsils after just one or two infections. Due to the risks associated with removing the tonsils, surgeons have become much more conservative. That said, tonsillectomy is frequently performed in the United States and complications are rare.

Tonsillectomy and Adenoidectomy (T&A)

The tonsils and adenoids are often removed at the same time by means of tonsillectomy and adenoidectomy, respectively. Combined these procedures are referred to by the abbreviation T&A.

Most people who receive T&A are children. Specifically, children with either recurrent bacterial infections that can't be treated with antibiotics or children with obstructed breathing secondary to enlarged tonsils and adenoids receive T&A. Typically, T&A is less painful for younger children than it is for either adolescents or adults.

Uncomplicated T&A is done in either in a hospital or clinic and is an outpatient procedure. In other words, the patient who receives a T&A doesn't need to spend a night in the hospital and can instead go home after a period of observation. However, very young children or children with severe obstructive sleep apnea may have to spend the night in the hospital.

What to Expect After T&A

Most children can take about seven to 10 days to fully recover after a T&A. Many children experience light bleeding within 24 hours following the surgery, in addition to fever and inflammation after the procedure. This inflammation or swelling can cause transient snoring. Furthermore, mild pain is often experienced after T&A. Adolescents and adults, however, often experience more severe pain. Options for pain control include pain relievers, such as acetaminophen, ibuprofen as well as prescription medications.

Tonsil bleeds may also occur again seven to 10 days after the surgery when the scabs (eschar) fall off.

During recovery, it's important to drink plenty of fluids and eat a soft diet. Some people lose weight during this period of convalescence because it can hurt to eat.

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  1. Rout MR, Mohanty D, Vijaylaxmi Y, Bobba K, Metta C. Adenoid Hypertrophy in Adults: A case Series. Indian J Otolaryngol Head Neck Surg. 2013;65(3):269-74. doi:10.1007/s12070-012-0549-y

  2. Wetmore RF. Surgical management of the tonsillectomy and adenoidectomy patient. World J Otorhinolaryngol Head Neck Surg. 2017;3(3):176-182. doi:10.1016/j.wjorl.2017.01.001

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