Tonsils are small, oval-shaped masses of lymphoid tissue located at the back of the throat, one on each side. These structures play a role in the body’s immune system, acting as a first line of defense against pathogens entering through the mouth and nose. They work by trapping germs and producing white blood cells and antibodies to help fight off infections. While tonsils are important for immune function, especially in early childhood, their removal does not typically compromise the immune system later in life.
Understanding Tonsils
Tonsils are part of the lymphatic system, a network that helps rid the body of unwanted materials. They are strategically positioned to sample bacteria and viruses, initiating an immune response. They contain white blood cells, which combat infections by developing immune cells and antibodies when exposed to germs. Although they serve a protective function, tonsils can sometimes become a source of recurring problems, leading to inflammation or obstruction.
What Healthy Tonsils Look Like
Healthy tonsils typically appear pink, similar in color to the surrounding throat tissue. They are usually symmetrical, meaning both tonsils are roughly the same size and shape. Healthy tonsils should not protrude significantly into the throat and are often barely visible or only slightly noticeable when viewed.
The surface of healthy tonsils should appear relatively smooth, without any prominent spots, streaks, or collections of pus. A consistent pink color and symmetrical, non-protruding presence indicate healthy tonsils.
Visual Signs Indicating Potential Removal
When tonsils are problematic, their appearance can change noticeably. Significant enlargement or swelling is a common sign, where tonsils appear visibly larger than normal and may even touch each other, a condition sometimes referred to as “kissing tonsils.” This can cause them to protrude prominently into the throat.
Redness and inflammation make the tonsils appear redder than the surrounding throat tissue. White spots, patches, or streaks often signal an active infection. Asymmetry, where one tonsil appears significantly larger or more inflamed than the other, can also be a concerning visual cue. Deep pits or crevices, known as crypts, may be visible on the tonsil surface, sometimes containing small, hard, white or yellowish debris called tonsil stones. These stones are formed from trapped bacteria and cellular debris.
Beyond Appearance: When Removal is Considered
Beyond visual cues, medical professionals consider several factors when recommending tonsil removal. Recurrent infections, such as tonsillitis, are a common reason. Guidelines often specify a certain frequency of infections over a period.
Severe enlargement of the tonsils can lead to airway obstruction, causing difficulty breathing, particularly during sleep, manifesting as snoring or obstructive sleep apnea. Large tonsils can also impede swallowing, causing discomfort or difficulty eating and drinking. A peritonsillar abscess, a collection of pus behind the tonsil, presents with extreme, often unilateral, swelling and requires urgent medical attention. Persistent asymmetry of the tonsils can sometimes warrant further investigation.