The tonsils are a crucial organ in the lymphatic system that helps the body to defend against bacterial infections and viruses. Without the tonsils, one would suffer endlessly from sore throats and other "ear, nose, and throat" infections. Although they are small, these organs are vital in keeping one healthy.
The word tonsil refers to any lump of tissue that filters blood or other bodily fluids. There are three main types of tonsils in the human body. The most common type of tonsils is the palatine tonsils. The palatine tonsils are small, almond-shaped lumps of lymphatic tissue measuring 1 by 0.5 inches. They are similar to lymph nodes as they are classified as members of the lymphatic system, a subsystem of the immune network. Palatine tonsils are located at the back of the throat, where the nasal cavity opens up in front of the breathing passages. The purpose of these palatine tonsils is to filter the blood and make a certain antibody specific to the lymphatic system called lymphocytes. "There is a popular myth that tonsils filter bacteria out of what we swallow and breathe, somewhat like a kitchen strainer. This is untrue. Any filter that could strain out microscopic bacteria would not allow the passage of any food particles and would make eating impossible" (Neustaedter, 247). The palatine tonsils' method of protecting the body from bacteria actually happens in two different ways. The first is the filtering of the blood from a vessel passing through the tonsil. The blood vessel passes through a narrow canal, called the crypt, located in the middle of the tonsil while white blood cells and lymphocytes are added to the blood. The second way the tonsil protects from bacteria involves the bacteria in the air we inhale being caught in the crypt outside of the tonsils when one inhales. This bacterium then travels through the crypt into the middle of the tonsil, where certain enzymes break and deactivate it.
In addition to the palatine tonsils, the lingual tonsils also protect the body. The lingual tonsils are located on the base of the tongue, in the back of the throat. These lymph nodes are constructed similar to the palatine tonsils with a narrow crypt leading to the middle of the node. The lingual tonsils measure from 1 to 0.5 inches and makeup about 1/4 of the tongue. They serve almost exactly the same purpose as the palatine tonsils, filtering blood vessels and excreting various white blood cells into the blood. These tonsils also catch bacteria from the air we inhale, similar to the palatine tonsils. When one inhales, the air moves over the crypt opening on the surface of the node. Any bacteria in the air are caught on the lymphatic tissue surrounding the opening of the crypt. The bacteria then follow the path as in the palatine tonsils. Experts believe that the purpose of having two sets of lymph nodes the same is strictly efficiency of defense. The lingual tonsils filter the air that the palatine tonsils miss.
The pharyngeal tonsils, or adenoids, are quite unlike the palatine and lingual tonsils. The pharyngeal tonsils are located at the back of the nose, where the nose blends in with the mouth. They are slightly farther back than the palatine tonsils. They measure from 0.5 inches to 0.8 inches, but can swell up to the size of ping-pong balls when infected. These tonsils do not have a crypt leading down to the middle of the node like the palatine and the lingual tonsils, but the pharyngeal tonsils also filter blood vessels. The blood vessel that the pharyngeal tonsil filters is only found in young infants and children because it fuses into another vessel during childhood. After this change, the function of the adenoids are limited and the node themselves begin to shrink. By adulthood, the functions of the adenoids are almost nonexistent and they are often removed. One other distinguishing characteristic of the adenoids are its walls. The epithelium of the tissues in the node is classified as pseudostratified columnar epithelium. This means that the sub-epidermal cells are elongated and the nuclei of the cells are pulled outward. The advantage of this type of epithelium is the strength of the tissue. Although there is not as much cell wall exposed, the wall is thicker and stronger.
The three lymph nodes discussed above, sometimes contract diseases and infections within its cells. In any of the tonsils, acute tonsillitis may occur in which the tonsils become inflamed and swollen causing a sore throat, fever, and trouble swallowing. Tonsillar hypertrophy also may occur in any of the tonsils. This swelling of the tonsils without inflammation may cause trouble sleeping, loud snoring, irregular breathing, or trouble swallowing. If any of these disorders and diseases reoccur or become serious, a tonsillectomy may consider an option. A tonsillectomy is “a surgical procedure in which the tonsils are removed” (Cohen 168). Although it sounds simple, the methods of the modern tonsillectomy greatly vary. The first method, and the most common, is the dissection and snare method. A wire snare is looped around the tonsil and used to cut the tissue. This method stresses the whole tonsils being removed and less post-operation bleeding occurs. Another method is electrocautery. This method uses a hand-held wand that heats up to 350oF, which then is used slowly to burn away the tissue around the tonsil. This variation minimizes bleeding but damages the throat tissue. An alternate method to this is the harmonic scalpel. This hand-held device has a scalpel head that vibrates 55,000 cycles per second. This is then used to cut the tissue around the tonsil. The result is precise cutting and minimal bleeding. Similar to the electrocautery, the thermal welding method uses pure thermal energy to seal and divide the tissue. There is minimum pain, minimum swelling, minimum bleeding, and a shortened recovery time. Doctors are calling this method, "Painless Tonsillectomy." A carbon dioxide laser can be used to vaporize and remove the surrounding tonsil tissue. This method also allows shortened recovery time and little to no bleeding and pain. The microdebrider is a rotary shaving device that quickly shaves individual layers of tissue off the tonsil. This method is commonly used to remove small cists on the tonsil and it is used when only part of the tonsil must be removed. Lastly, the coblation method produces "an ionized saline layer that disrupts molecular bonds without using heat. This method results in less pain, faster healing, and less postoperative care according to some studies.
In conclusion, the tonsils are vital members of the lymphatic system that take a valuable part in keeping our bodies healthy and bacteria-free. However, if a set of tonsils do become infected and risk a serious "whole body" infection, the tonsils may be removed without serious repercussions.
