Tonsils and Adenoids
The tonsils are two masses of tissue found on either side of the back of the throat. The adenoids are located high in the throat behind the nose and roof of the mouth. Together they form part of the ring of glandular tissue at the back of the throat. The tonsils and adenoids assist the body in defense against infection by "sampling" entering bacteria and viruses and becoming infected themselves. They then help form antibodies to resist and fight future infections.
However, the tonsils and adenoids often become susceptible to recurrent bacterial infections and obstruction that may lead to breathing, swallowing and sleep problems. These conditions are most common in children.
Tonsillitis is an inflammation of the tonsils, the fleshy areas at the back of the throat, caused by a virus or bacteria. This condition is common in children and spreads through contact with throat or nasal fluids. The tonsils become swollen, red and painful and may be coated with a yellow or white substance.
Most cases of tonsillitis are caused by a virus, although it can sometimes be caused by the same bacteria that causes strep throat. Tonsillitis symptoms are similar to those of strep throat or a common cold and may include:
- Sore throat
- Red, swollen tonsils
- Difficulty swallowing
- Swollen lymph nodes
This condition can be diagnosed through a rapid strep test.
Enlargement of Tonsils and Adenoids
The tonsils and adenoids may become enlarged as a result of bacterial infection. Enlargement may lead to obstructions within the airway, which as a result can cause problems with sleeping or breathing. While most cases of enlarged tonsils or adenoids return to their normal size once the infection has been treated, they may remain enlarged in patients with frequent or chronic infections.
This condition often causes a sore throat and discomfort during swallowing, as well as creating a nasally sound to the voice. If not managed properly, enlarged tonsils and adenoids may lead to chronic ear infections, hearing loss, obstructive sleep apnea and other serious complications.
- Chronic tonsillitis or persistent infection of the tonsils
- Peritonsillar abscess, a collection of pus behind the tonsils that can lead to life-threatening complications if left untreated
- Enlargement of (hypertrophic) tonsils and adenoids, which can obstruct breathing and lead to sleep irregularities, among other problems
Bacterial infections of the tonsils and adenoids can be treated with various antibiotics. Patients can also help relieve symptoms by getting rest and drinking plenty of liquids. Surgical removal is considered when conditions are resistant to medical therapy or frequently recur. Surgery may be recommended for patients experiencing six to seven episodes per year, four to five episodes a year for a two-year period, or three episodes per year for a three-year period.
Tonsillectomy and Adenoidectomy
Surgical removal of these structures is performed through a tonsillectomy or adenoidectomy. These procedures are performed on an outpatient basis under general anesthesia, and may be performed separately or together as an adenotonsillectomy. Your doctor will decide which treatment is best for you after a thorough evaluation of your individual condition.
In some cases, these procedures may be performed using electrocautery, laser energy or radiofrequency ablation, although traditional removal with a scalpel is most common. In addition to reducing the frequency of recurring infections, tonsillectomy and adenoidectomy can also make eating and speaking easier, reduce snoring and treat obstructive sleep apnea in patients suffering from these complications.