tonsils should be removed. In the 1940s tonsillectomy became controversial as several studies linked it to bulbar poliomyelitis. From the 1940s to 1970s, further studies found an association between tonsillectomy and bulbar poliomyelitis with recommendations not to do the operation during outbreaks. Controversy surrounding tonsillectomy increased further in the United Kingdom in the 1960s because of the financial costs associated with the number of surgeries being performed and because of unexplainable variations in tonsillectomy rates between geographic regions and between social classes. In the media, tonsillectomy was criticised for being "fashionable" or a "status symbol". There was also an increasing concern regarding the psychological and physical suffering of young children as a result of surgery. Furthermore, opponents of surgery argued that the tonsils should be retained whenever possible because of their role in the immune system and that the benefits of surgery were marginal. In the 1970s, tonsillectomy rates in the United Kingdom started to decline after several studies concluded that tonsillectomy was not as effective for sore throats and many other indications as previously thought. Tonsillectomy rates in the United States have declined since 1978, when experts of the National Institutes of Health concluded that there was insufficient evidence that the benefits of tonsillectomy outweighed the risks and therefore recommended more research, which subsequently led to stricter guidelines. As doctors took a more conservative approach towards tonsillectomy, parental pressure became one of the most important reasons for surgery. References External links Tonsillectomy Procedures History of tonsillectomy Surgical removal procedures Tonsil Sleep surgery