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Over the last years I have attended a number of sleep related courses and another conventional wisdom seems to be failing.

The conventional wisdom since the 1960’s is to save all tonsils. Before this it was almost to remove all tonsils.

I accepted the conventional wisdom uncritically but now it seems to be have become an extreme position, in other words the truth is that most tonsils are better kept but that many should not be.

If someone has enlarged tonsils that block the airway it seems that removal maybe the best option. The same goes for adenoids.

It seems to be more important that people are able to breathe at night than to keep enlarged tonsils and adenoids.

There seem to be developing a view that one can do with out tonsils after about age 7. In facial pain cases over and over again when we get to the final cause of the headaches, neck aches and clenching, it turns out to be inability to get air through the nose. Usually this will respond well to allergy treatments but occasionally the surgical (ENT) solution is the best.