Tonsils and Adenoids

Tonsils and adenoids are part of the body’s first line of defense—our immune system. They “sample” bacteria and viruses that enter the body through the mouth or nose, at the risk of becoming infected. But sometimes, they are more of a liability than an asset and may even cause airway obstruction or repeated bacterial infections. Your ear, nose, and throat specialist can suggest the best treatment options.

What are tonsils and adenoids?

Tonsils and adenoids are two masses of tissue that are similar to the lymph nodes that are found in the neck, groin, and armpits. Tonsils are the two masses on the back of the throat and the adenoids are high in the throat behind the nose and the roof of the mouth, and are not visible through the mouth without the use of special instruments.

What problems affect tonsils and adenoids?

The most common problem that affects the tonsils and adenoids are recurrent infections and significant enlargement or obstruction that causes breathing, swallowing, and sleep problems. Abscesses around the tonsils, chronic tonsillitis, and infections of small pockets within the tonsils that produce foul-smelling, cheese-like formations can also affect the tonsils and adenoids, making them sore and swollen. Tumors are rare but can grow on the tonsils.

When should I see a doctor?

You should see your doctor when you or your child suffer the common symptoms of infected or enlarged tonsils or adenoids. Your doctor will ask you about problems of ears, nose, and throat, and examine your head and neck. Your doctor will use a small mirror or a flexible lighted instrument to view your tonsils.

Methods used to asses tonsils and adenoids include:

  • Medical history
  • Physical examination
  • Throat cultures/Strep tests – identify infections in the throat
  • X-rays – assess the size and shape of the adenoids
  • Blood tests – detect infections such as mononucleosis

How are tonsil and adenoid diseases treated?

Bacterial infections of the tonsils, especially those caused by Streptococcus, are treated with antibiotics. Sometimes, removal of the tonsils and/or adenoids may be recommended if there are recurrent infections despite antibiotic therapy or difficulty breathing due to enlarged tonsils or adenoids. Such obstruction to breathing can cause snoring and disturbed sleep that leads to daytime sleepiness in adults and behavioral problems in children.

Chronic infection can affect other areas such as the eustachian tube – the passage between the back of the nose and the inside of the ear. This can lead to frequent ear infections and hearing loss. Recent studies suggest that an adenoidectomy may be a beneficial treatment for some children with chronic earaches accompanied by fluid in the middle ear — otitis media with effusion.

The possibility of cancer or a tumor may be another reason that warrants the removal of the tonsils and adenoids. In some patients, especially those with infectious mononucleosis, severe enlargement may obstruct the airway. For those patients, treatment with steroids may be helpful.

How to prepare for surgery

Children

  • Talk to your child about their feelings.
  • Provide strong reassurance and support.
  • Promote the idea that the procedure will make them healthier.
  • Be with your child before and after the surgery.
  • Tell them to expect a sore throat after surgery.
  • Reassure your child that the operation does not remove any important parts of the body and that they will not look any different.
  • If your child has a friend who has had this surgery, it may be helpful to talk about it with that friend.

Adults and children
For at least two weeks before any surgery, you should refrain from taking aspirin or other medications containing aspirin. If you or a family member has had any problems with anesthesia, the surgeon should be informed. If you are taking any other medications, have sickle cell anemia, have a bleeding disorder, are pregnant, have concerns about blood transfusions, or have used steroids in the past year, your surgeon should be informed. A blood test and urine test may be required prior to surgery. There will be a period of time before surgery when nothing may be taken by mouth. When you arrive at the surgery center, staff will meet with you to review your history. You will be taken to the operating room and given an anesthetic. Intravenous fluids are usually given during and after surgery. After the operation, you will be taken to the recovery area. Recovery room staff will observe you until it is safe to be discharged. Every patient is unique, and recovery times may vary. Your ENT specialist will provide you with the details of pre-operative and postoperative care and answer any questions you may have.

After surgery

There are several postoperative symptoms you may experience including — but not limited to — swallowing problems, vomiting, fever, throat pain, and ear pain. Occasionally, bleeding may occur after surgery. If you have any bleeding, your surgeon should be notified immediately. Any questions or concerns you have should be discussed openly with your surgeon.

Tonsillitis and its symptoms

Tonsillitis is an infection in one or both tonsils. One tell-tale sign of tonsilitis is swelling of the tonsils. Other signs and symptoms include:

  • Redder than normal tonsils
  • A white or yellow coating on the tonsils
  • A slight voice change due to swelling
  • Sore throat
  • Uncomfortable or painful swallowing
  • Swollen lymph nodes (glands) in the neck
  • Fever
  • Bad breath

Enlarged adenoids and its symptoms

If you or your child’s adenoids are enlarged, it may be hard to breathe through the nose. Other signs and symptoms include:

  • Mouth breathing
  • Nasally speech
  • Noisy breathing
  • Recurrent ear infections
  • Snoring at night
  • Sleep apnea

If you have concerns about your tonsils or adenoids or have any of the symptoms listed above, it is best to have your tonsils and adenoids assessed by an ENT specialist. For a local ENT doctor in Fort Collins, schedule your appointment at Alpine Ear, Nose and Throat. Contact us today!