# When and why did tonsillectomies stop being routinely done on kids? **URL:** \ **Category:** Factual Questions\ **Created:** [March 16, 2018, 1:09pm UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659 "2018-03-16T13:09:23Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![UncaStuart](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/uncastuart/32/404_2.png) [@UncaStuart](https://boards.straightdope.com/u/UncaStuart)\ **Post date:** [March 17, 2018, 12:52am UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/41 "2018-03-17T00:52:45Z")
Born in '47, had adenoids and tonsils out around '52. My memory is that it was more or less SOP at the time. I don’t recall any strep or ear issues leading up to the procedure, and with the parents and the surgeon not around to ask anymore, that’ll remain a mystery. I do recall the surgeon saying that he “took a hat-full of adenoids” out. With me being diagnosed with sleep apnea at 64, I wonder how much sooner that would have appeared if I still had had the hat-full hanging around. ---
**Author:** ![Andy\_L](https://avatars.discourse-cdn.com/v4/letter/a/c67d28/32.png) [@Andy\_L](https://boards.straightdope.com/u/Andy_L)\ **Post date:** [March 17, 2018, 2:22am UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/42 "2018-03-17T02:22:18Z")
Here’s some data [https://www.healthguideinfo.com/ear-nose-throat/p33464/](https://www.healthguideinfo.com/ear-nose-throat/p33464/) "Tonsillectomy and adenoidectomy rates in the United States have varied over the last fifty years, following a general pattern of decline. In hospitals in 1965, the tonsillectomy rate in the U.S. was 63.4 per 10,000 for all age groups, and 165.6 per 10,000 for children under 15 [1]. Two decades later (1986), these rates had dropped to 11.7 per 10,000 for all age groups and 33.9 per 10,000 for children under 15 [1]. Between 1990-91 and 2000, the hospital tonsillectomy rate for children under 18 dropped from 10.7 per 10,000 to 2.1 per 10,000 [2]." Had mine out in 1968 or so - barely remember it. It was pretty routine back then as I recall (note that Cindy Brady and Little Ricky both had tonsils out on TV). ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [March 17, 2018, 3:40am UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/43 "2018-03-17T03:40:20Z")
> [@Bayard](#): > > Could it be that issues that used to be treated by yanking the tonsils out are now more often (and more safely) treated with antibiotics and other medication? My WAG. You nailed it! Tonsils and adenoids are not removed nowadays unless they are obviously chronically diseased. Even though kids usually go home the same day, and adults the next, it is NOT a “minor” procedure just because it doesn’t involve a skin incision. When I was growing up in the 1970s, our parents were asked more than once, “So, when are you going to have your kids’ tonsils out?” and they always replied, “When and if it needs to be done.” As it turned out, none of us did, and some of that came from my dad remembering his own tonsillectomy when he was a little boy. He said it was a very traumatic experience, especially because it may not have been necessary. I’ve personally known several people, including a high school friend, who were thought to have assorted chronic or even “psychosomatic” diseases, until they were discovered to have abscessed tonsils. They were creating atypical symptoms, but removing them led to vastly improved health. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [March 17, 2018, 3:43am UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/44 "2018-03-17T03:43:39Z")
> [@Qadgop\_the\_Mercotan](#): > > These days, T & A is indicated if there are significant problems with obstruction or infection. Current recommendations per UpToDate: > There are other reasons to have the procedure, but it certainly is de-emphasized over what it was prior to the early 1970’s. In origin, it was felt that prophylactically removing tonsils before they became a problem would prevent not only a lot of strep throat, but also rheumatic heart and kidney disease. Doctors of earlier eras saw a lot of kids get damaged, or die, from strep infections. Rheumatic fever - now, THAT’S a disease that (it seems) nobody gets any more, and thank heavens! In 18 years of active pharmacy practice, I never encountered a case, although I did work with one pharmacist who would now be in his early 70s, and before I met him underwent a heart valve replacement due to rheumatic heart disease. :eek: ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [March 17, 2018, 3:45am UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/45 "2018-03-17T03:45:32Z")
> [@Hari\_Seldon](#): > > I had mine out when I was six years old in 1943 and it was done routinely. They sweetened the pot by promising ice cream after. It did soothe the sore throat. I have the impression that it was just a reluctance to put kids under general anesthetic. Like any such procedure there were very rare deaths. > When I had to have my appendix out in 1950, they did it under local (spinal). None of my kids ever had it done. General anesthesia was much more dangerous back then, especially for children, than it is now. ---
**Author:** ![Ignotus](https://avatars.discourse-cdn.com/v4/letter/i/ecc23a/32.png) [@Ignotus](https://boards.straightdope.com/u/Ignotus)\ **Post date:** [March 17, 2018, 4:15am UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/46 "2018-03-17T04:15:25Z")
_Is_ there, in fact, any such thing as “tonsils”, or is it just a doctor’s buzzword for any designated part of the mucous membrane of the throat, just as arbitrary as the hymen? ---
**Author:** ![Beckdawrek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beckdawrek/32/3647_2.png) [@Beckdawrek](https://boards.straightdope.com/u/Beckdawrek)\ **Post date:** [March 17, 2018, 4:19am UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/47 "2018-03-17T04:19:50Z")
My oldest is the only one to have his tonsils out. We pretty much had to beg pediatrician to refer us the ENT. When he got mononucleosis we insisted. The ENT took one look at his throat and said “those tonsils are diseased, should of been removed a year ago”. He did great and never had sore throat again. This was in the 90s. ---
**Author:** ![TSBG](https://avatars.discourse-cdn.com/v4/letter/t/77aa72/32.png) [@TSBG](https://boards.straightdope.com/u/TSBG)\ **Post date:** [March 17, 2018, 4:22am UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/48 "2018-03-17T04:22:09Z")
I’m not a medical historian, but there seems to have been a sort of inflection point where doctors started realizing “tonsillectomies/adenoidectomies may not be necessary.” No doubt the doctors here will correct me. But I remember fairly vividly as a child (US, early 70s) hearing from my parents that my tonsils and adenoids (and appendix) would have to be removed. None ever were though. I haven’t had problems with any so far. OTOH, my wife gets tonsil infections a lot and wishes they had been taken out. She’s a only a few years younger than me but it seems the anti-removal wave broke over us, for good or ill. I have a friend whose 2-yr old seems to have a chronic tonsil infection and it may be that removal is the best solution. I’m more worried than he is–he’s the “I don’t go to the doctor” type and I worry he doesn’t realize how serious an operation is. However, it may be the best option for her. ---
**Author:** ![gnoitall](https://avatars.discourse-cdn.com/v4/letter/g/bb73d2/32.png) [@gnoitall](https://boards.straightdope.com/u/gnoitall)\ **Post date:** [March 17, 2018, 4:43am UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/49 "2018-03-17T04:43:19Z")
> [@Ignotus](#): > > _Is_ there, in fact, any such thing as “tonsils”, or is it just a doctor’s buzzword for any designated part of the mucous membrane of the throat, just as arbitrary as the hymen? There is no tonsil conspiracy. Tonsils are very [specific lymphoid organs](https://en.wikipedia.org/wiki/Tonsil#Structure). They’re not part of the mucosa, the same way the tongue or salivary glands aren’t. ---
**Author:** ![Ignotus](https://avatars.discourse-cdn.com/v4/letter/i/ecc23a/32.png) [@Ignotus](https://boards.straightdope.com/u/Ignotus)\ **Post date:** [March 17, 2018, 4:50am UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/50 "2018-03-17T04:50:49Z")
> [@gnoitall](#): > > There is no tonsil conspiracy. > > Tonsils are very [specific lymphoid organs](https://en.wikipedia.org/wiki/Tonsil#Structure). They’re not part of the mucosa, the same way the tongue or salivary glands aren’t. So, how come they’re not a problem here in Europe? Sure, we’ve all had sore throats once or thrice: it usually comes with a dripping nose, and goes away with it. But I’ve never heard a doctor suggest that removal of some part of the epithel of the throat would serve to lessen that problem! ---
**Author:** ![Ludovic](https://avatars.discourse-cdn.com/v4/letter/l/7ab992/32.png) [@Ludovic](https://boards.straightdope.com/u/Ludovic)\ **Post date:** [March 17, 2018, 12:02pm UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/51 "2018-03-17T12:02:13Z")
My younger brother had his tonsils taken out in the early 80s due to recurring throat infections. I never had mine taken out because I never had very many throat infections. Anecdotally it seemed that there were a lot more references to taking one’s tonsils out in the 70s and 80s than there are today so the practice, while dying out, seemed to be more common than it is today. ---
**Author:** ![markn\_1](https://avatars.discourse-cdn.com/v4/letter/m/f9ae1b/32.png) [@markn\_1](https://boards.straightdope.com/u/markn_1)\ **Post date:** [March 17, 2018, 2:29pm UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/52 "2018-03-17T14:29:15Z")
> [@Ignotus](#): > > So, how come they’re not a problem here in Europe? Sure, we’ve all had sore throats once or thrice: it usually comes with a dripping nose, and goes away with it. But I’ve never heard a doctor suggest that removal of some part of the epithel of the throat would serve to lessen that problem! In 2003–2004 in England, 50,224 tonsillectomies were performed. In 2012-2013, 46,830 were performed. [cite](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4474098/) In 2006-2013 in Germany, 833,896 tonsillectomies were performed. [cite](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5169081/) [This table](http://ec.europa.eu/eurostat/statistics-explained/index.php/File:Selected_large_decline_procedures_performed_in_hospitals,_2010_and_2015_(per_100_000_inhabitants)_HLTH17.png) shows tonsillectomy rates for a number of European countries in 2010 and 2015. The 2015 rates range from 12.1 per 100,000 population (Iceland) to 217.9 per 100,000 (Belgium). It certainly doesn’t seem that this procedure is unknown in Europe. ---
**Author:** ![jz78817](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jz78817/32/1028_2.png) [@jz78817](https://boards.straightdope.com/u/jz78817)\ **Post date:** [March 17, 2018, 2:38pm UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/53 "2018-03-17T14:38:13Z")
> [@markn\_1](#): > > In 2003–2004 in England, 50,224 tonsillectomies were performed. In 2012-2013, 46,830 were performed. [cite](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4474098/) > > In 2006-2013 in Germany, 833,896 tonsillectomies were performed. [cite](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5169081/) > > [This table](http://ec.europa.eu/eurostat/statistics-explained/index.php/File:Selected_large_decline_procedures_performed_in_hospitals,_2010_and_2015_(per_100_000_inhabitants)_HLTH17.png) shows tonsillectomy rates for a number of European countries in 2010 and 2015. The 2015 rates range from 12.1 per 100,000 population (Iceland) to 217.9 per 100,000 (Belgium). > > It certainly doesn’t seem that this procedure is unknown in Europe. it’s as if Europe isn’t a monoculture or something. ---
**Author:** ![pudytat72](https://avatars.discourse-cdn.com/v4/letter/p/ce7236/32.png) [@pudytat72](https://boards.straightdope.com/u/pudytat72)\ **Post date:** [March 17, 2018, 5:15pm UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/54 "2018-03-17T17:15:48Z")
38 years as a doctor in Family Practice and Urgent care, I have recommended a patient have their tonsils removed 3 times (early 1980’s, 1993, and 2018). All three (including my 9 year old son) had recurring strep infections and growth failure. My son told me a week after his surgery: “MOM! I didn’t know I could feel so good!” ---
**Author:** ![Jeff\_Lichtman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jeff_lichtman/32/1531_2.png) [@Jeff\_Lichtman](https://boards.straightdope.com/u/Jeff_Lichtman)\ **Post date:** [March 17, 2018, 5:15pm UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/55 "2018-03-17T17:15:53Z")
My older brother had a tonsillectomy and I didn’t. He was born in 1955, and I was born in 1957. It could just be that he had more sore throats than I did, but it’s also possible that routine tonsillectomies were going of style in the early sixties. I think tonsillectomies became less common for several reasons: tonsillitis was less dangerous than it used to be because of antibiotics; even minor surgery carries risks; surgery is scary and recovery is painful, and pediatricians and parents don’t want children to suffer needlessly; tonsils are functional organs, not useless appendages; medical costs were increasing even back then. ---
**Author:** ![ThelmaLou](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/thelmalou/32/390_2.png) [@ThelmaLou](https://boards.straightdope.com/u/ThelmaLou)\ **Post date:** [March 17, 2018, 8:01pm UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/56 "2018-03-17T20:01:34Z")
> [@pudytat72](#): > > …My son told me a week after his surgery: “MOM! I didn’t know I could feel so good!” What a great thing to hear! 🙂 ---
**Author:** ![Melbourne](https://avatars.discourse-cdn.com/v4/letter/m/b5e925/32.png) [@Melbourne](https://boards.straightdope.com/u/Melbourne)\ **Post date:** [March 17, 2018, 10:06pm UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/57 "2018-03-17T22:06:28Z")
First oral penicillin was available ~ 1953. So that was when you could first give a patient some pills and say come back in a few weeks and we will see if you still need tonsil removal. Actually, I don’t remember oral antibiotics until the 70’s - I was still getting penicillin injections in '68 - and you wouldn’t want to keep a kid in hospital for a few weeks to see if tonsillitis resolved with antibiotic treatment every 8 hours. (Or at least, you wouldn’t have wanted to then. Attitudes to surgery have changed again) ---
**Author:** ![Shinna\_Minna\_Ma](https://avatars.discourse-cdn.com/v4/letter/s/f08c70/32.png) [@Shinna\_Minna\_Ma](https://boards.straightdope.com/u/Shinna_Minna_Ma)\ **Post date:** [March 17, 2018, 10:49pm UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/58 "2018-03-17T22:49:55Z")
I had my tonsils out in 1969, when I was 7 years old. I believe I had about 3 straight months of strep throats before they finally came out. I still remember one of the songs playing on the radio as we drove to the hospital in my Dad’s blue Corvair - “Brother Love’s Traveling Salvation Show,” Neil Diamond. Still my favorite Neil Diamond song. I remember sitting up on the gurney and looking around the OR when we entered. A nurse came over and pushed me back down. I slept so long after the surgery that my mom allegedly became hysterical, thinking I was never going to wake up. ---
**Author:** ![smithsb](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/smithsb/32/12107_2.png) [@smithsb](https://boards.straightdope.com/u/smithsb)\ **Post date:** [March 18, 2018, 8:48am UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/59 "2018-03-18T08:48:48Z")
I had mine out in the mid 50’s around age 8. Multiple sore throats EVERY year! I remember the procedure with a screen-like device and dripping ether on it while I counted backwards. Man, I was out like a shot and ether gives you hangover headache. I was promised anything I wanted to eat after surgery like jello, ice cream, custard pudding. I asked for french fries 😃 I got ice cream 😕 ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [March 18, 2018, 9:11am UTC](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659/60 "2018-03-18T09:11:24Z")
> [@Bayard](#): > > Could it be that issues that used to be treated by yanking the tonsils out are now more often (and more safely) treated with antibiotics and other medication? My WAG. Mine came out in 1978 at age 10, but it was after months of recurring tonsillitis with anemia as a side effect; there had come a point where I just “got tonsillitis again” every single week. While better care would probably have been able to solve the problem (letting the damned tonsils heal completely rather than sending me back to school before the antibiotics were even over), the doctors couldn’t surgically set my parents’ heads on straight. Neither my brothers nor any of my cousins (I’m among the eldest) got them out as children, and everybody my age or younger I know who got them out either as children or adults, it was after months of having problems. I hadn’t known it was possible to get tired of flan and ice cream. Turns out, it is! [Previous page](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659.md?page=2) [Next page](https://boards.straightdope.com/t/when-and-why-did-tonsillectomies-stop-being-routinely-done-on-kids/810659.md?page=4)