Get to Know Your Tonsils

There Are 3 Pairs of Tonsils in the Throat

Doctor examining girl with tongue depressor in clinic

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It's not uncommon for people to ask, "What are tonsils?" After all, they don't have a use that immediately comes to mind, like the hand does, for instance. Let's dig into what tonsils are and the function they serve.

3 Pairs of Tonsils in the Throat

  • 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

These specialized organs are part of the lymphatic system and provide our body’s first protective barrier from foreign substances that we inhale or ingest through the nose or mouth. Once trapped in the tonsils, the bacteria or viruses are then transported to lymph nodes where specialized immune cells cluster to fight infection.

A bit contrary to their function the tonsils can also 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. This is called a tonsillectomy. 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 (TNA)

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 TNA. Most people who receive TNA 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 TNA. Typically, TNA is less painful for younger children than it is for either adolescents or adults.

Uncomplicated TNA is done in either in a hospital or clinic and is an outpatient procedure. In other words, the patient who receives a TNA 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 TNA

Most children can take about 7 to 10 days to fully recover after a TNA. Many children experience light bleeding, fever, and inflammation after the procedure. This inflammation or swelling can cause transient snoring. Furthermore, mild pain is often experienced after TNA. 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.

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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Article Sources

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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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