The almonds - better than their reputation

It has been around for about 100 years, the most common scheduled surgery - the removal of the palatine tonsils (also: tonsillectomy). In the 1960s, it was routinely used to prevent complications. Today, the almonds' function is valued higher in the body's own defense system.

Defense function of the tonsils

The palatine tonsil belongs to the so-called lymphatic pharyngeal ring, which is formed by lymphatic tissue collections in various regions of the pharynx. This ring is part of the immune system and has an important defense against invading germs. Therefore, today the operation is only used for well-defined disease states, namely:

  • recurrent acute tonsillitis (more than three times a year)
  • Tonsillitis, which does not heal despite the administration of antibiotics or when an abscess (collection of pus) forms
  • chronic tonsillitis
  • Enlarged palatine tonsils that interfere with breathing

What are the clinical pictures?

An acute inflammation of the palatine tonsils ( angina tonsillaris ) occurs through the penetration of viruses or bacteria into the throat area. Especially children between the ages of five and eleven are affected by the so-called "angina". It comes to heavy swallowing and high fever; the general condition is very limited.

If it is a viral infection, inflammation and pain usually resolve after one to three days without special therapy. In a bacterial infection mostly bacteria from the group of streptococci are responsible. The tonsils are inflammatory swollen, crimson and have white to yellowish, strip-like, punctate or greasy deposits. A typical accompanying symptom is unpleasant halitosis.

The infection with bacteria can be really dangerous if an abscess forms on the inflamed tonsils, ie a collection of pus. The pus needs to be surgically removed as soon as possible. The almonds are usually taken in the same session. Accompanying the patients receive antibiotics.

Chronic tonsillitis

Chronic tonsillitis occurs when the almond surface depressions permanently deposit bacteria and dead cell parts that sustain the inflammation. There is a rupture of the surface and scarring of the tissue. Many sufferers do not notice the infection because they have no symptoms. Some have mild dysphagia or an unpleasant taste and bad breath. On pressure pus pours out of the small dimples on the almond surface.

Antibiotics no longer reach the almond tissue. The bacterial colonization can also act as a source of spill: Bacteria and messenger substances from there into the blood, can be carried to other organs and cause infections. If a chronic tonsillitis is kidnapped, kidney and heart valves are threatened, and it can come to Rheumatic fever.

Children need their almonds

The almonds have a "good image" today. They are especially in children as a "guard" against virus and bacterial attacks. They act as biological filter organs and can intercept germs that have entered the blood and lymph channels. Studies show that premature almond removal can affect the performance of the child's immune system for years.

Therefore children are usually removed from the age of six months. Important: In case of chronically inflamed tonsils or inflammation with abscess formation, the tonsils must be removed even in infancy!

What complications occur?

The surgery is a short procedure that is usually performed under general anesthesia. The doctor separates the two palate tonsils at the so-called Mandelpol. The procedure is performed inpatient because there is a risk of rebleeding. Most often, these occur on the day of the operation and on the first day thereafter. But even on the fifth and sixth day, when the whitish wounds detach from the almond beds, there is a risk.

Because these bleedings can be massive and life-threatening, they require immediate medical intervention. Therefore, patients usually stay in hospital for six to seven days for observation. In a small percentage of cases, side-branch anginae, ie inflammation of the lateral wall of the pharynx, are more common after surgery. Important: A weakening of the body's immune system is not to be feared in adults, as there is still enough lymphatic tissue remaining in the pharynx after surgery.


A palatine tonsil removal due to constant inflammation or a chronic disease leads almost immediately to an improvement or healing of the existing clinical picture. Especially in childhood, the previously existing susceptibility to infection decreases significantly. Experience also shows that children who have been affected by constant infections in their physical development, make progress very quickly after the operation.

Are there alternatives to the operation?

There is no alternative to surgery in case of enlargement of the tonsils and chronic tonsillitis. In the case of an abscess, an incision opening can be made instead of the distance to drain the pus. But then almonds should be removed every few weeks.

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