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10 Fascinating Facts About the Tonsils

Mental Floss logo Mental Floss 27-01-2019 Jordan Rosenfeld

The human body is an amazing thing. For each one of us, it's the most intimate object we know. And yet most of us don't know enough about it: its features, functions, quirks, and mysteries. Our series The Body explores human anatomy, part by part. Think of it as a mini digital encyclopedia with a dose of wow.

Most of us only become aware of our tonsils if they become swollen or infected, as in the condition tonsillitis. But these masses of lymphatic tissue in the mouth and throat are considered "immunological guardians of the upper aerodigestive tract," according to a 2016 study in the Encyclopedia of Immunobiology. To learn more about the tonsils, Mental Floss spoke to Raja Seethala, the director of head and neck pathology at the University of Pittsburgh Medical Center and a member of the College of American Pathologists Cancer Committee, and Donald Levine, an ear, nose, and throat specialist in Nyack, New York.

1. YOU ACTUALLY HAVE FOUR KINDS OF TONSILS.

When used in the general sense, the term tonsils usually refers to your palatine tonsils, the ones that can be seen at the back of your throat. But tonsillar tissue also includes the lingual tonsil (located in the base of the tongue), tubal tonsils, and the adenoid tonsil (often referred to in the plural). "Collectively, these are referred to as Waldeyer's ring," Seethala explains to Mental Floss.

2. THEY ARE ONE OF YOUR BODY'S FIRST RESPONDERS TO PATHOGENS.

10 Fascinating Facts About the Tonsils © iStock 10 Fascinating Facts About the Tonsils

The tonsils are key first responders to inhaled or ingested pathogens that can cause infection or other harm, Seethala says. "These pathogens bind to specialized immune cells in the lining—epithelium—to elicit an immune response in the lymphoid T and B cells of the tonsil." Essentially, they help begin your immune response.

3. ADENOIDS CAN OBSTRUCT BREATHING AND CAUSE FACIAL DEFORMITIES.

If the adenoids become enlarged, they can block breathing and clog up your sinus drainage, which can cause sinus and ear infections. If adenoids are too big, it forces a person to breathe through their mouth. In children, frequent mouth breathing has the potential to cause facial deformities by stressing developing facial bones. "If the tonsils are too large and cause airway obstruction, snoring, or obstructive sleep apnea, then removal is important," says Levine. Fortunately, the adenoids tend to get smaller naturally in adulthood.

4. AS MANY OF US KNOW, SOMETIMES THE TONSILS NEED TO GO.

Even though your tonsils are part of your immune system, Levine says, "when they become obstructive or chronically infected, then they need to be removed." The rest of your immune system steps in to "handle further infectious assaults." Another reason to remove tonsils besides size, Levine says, is "chronic tonsillitis due to the failure of the immune system to remove residual bacteria from the tonsils despite multiple antibiotic therapies."

5. TONSILLECTOMIES HAVE BEEN PERFORMED FOR MILLENNIA.

The idea of removing a tonsil is believed to have been in existence for three millennia. The procedure is found in ancient Ayurvedic texts, says Seethala, "making it one of the older documented surgical procedures." But though the scientific understanding of the surgery has changed dramatically since then, "the benefits versus harm of tonsillectomy have been continually debated over the centuries."

6. EARLY TONSILLECTOMIES WERE PROBABLY QUITE PAINFUL.

The first known reported case of tonsillectomy surgery, according to a 2006 paper in Otorhinolaryngology, is by one Cornélio Celsus, a Roman "encylopaediest" and dabbler in medicine, who authored a medical encyclopedia titled Of Medicine in the 1st century BCE. Thanks to his work, we can surmise that a tonsillectomy probably was an agonizing procedure for the patient: "Celsus applied a mixture of vinegar and milk in the surgical specimen to hemostasis [staunch bleeding] and also described his difficulty doing that due to lack of proper anesthesia."

7. THE SURGERY WAS PERFORMED FOR HIGHLY UNLIKELY REASONS.

The same paper reveals that among some of the more outlandish reasons for removing tonsils were such distinctly un-tonsil-related conditions as "night enuresis (bed-wetting), convulsions, laryngeal stridor, hoarseness, chronic bronchitis, and asthma."

8. EARLY TREATMENTS INCLUDED FROG FAT AND OILS.

As early practitioners struggled to perfect techniques for removing tonsils effectively, another early physician, Aetius de Amida, recommended such treatments as "ointment, oils, and corrosive formulas with frog fat to treat infections."

9. MODERN TONSILLECTOMY IS, THANKFULLY, MUCH MORE SOPHISTICATED.

A common technique today for removing the tonsils, according to Levine, is a far cry from the painful early attempts. Under brief general anesthesia, Levine uses a process called coblation. "[It's] a kind of cold cautery, so there is almost no bleeding, less post operative pain, and quicker healing. You can return to normal activities 10 days later," Levine says. 

10. ONE KIND OF TONSIL CANCER IS A SEXUALLY TRANSMITTED DISEASE.

In contrast to other head and neck sites, the incidence of tonsillar cancers is increasing, according to Seethala. "Unlike other head and neck cancers, which are commonly associated with smoking and alcohol, tonsillar cancers are driven by high-risk human papillomavirus (HPV)," he says. He notes, "HPV-related tonsillar cancer can be considered sexually transmitted."

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