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Tonsils and adenoids are lymphoid tissue, part of the body’s immune system. The tonsils are bumps found on each side of the upper throat while the adenoids are not visible – located just behind the nose and above the soft palate. The tonsils and adenoids play only a small role in the function of the immune system, but they are frequently the target of infection or cause symptoms by their enlargement.

Tonsillitis – is an infection of the tonsils which may cause

  • Redness, swelling or coating on the tonsils
  • Sore throat, sometimes accompanied by ear pain
  • Painful or difficult swallowing
  • Swollen neck lymph nodes, fever or bad breath

Adenoiditis – is an infection of the adenoids which may create

  • Nasal obstruction resulting in mouth breathing
  • A “nasal” quality to speech
  • Chronic running nose or snoring at night
  • Recurrent ear infections

Chronic (repeated) infections of the tonsil and adenoids can also cause persistent enlargement of these tissues, which can lead to sleep apnea or other sleep disorders. Other problems include abscesses around the tonsil (peritonsillar abscess) and crevices or small pockets within the tonsils which cause soreness and bad breath. Finally, cancer of the tonsil may occur – often related to smoking or HPV infection, requiring prompt diagnosis and therapy.

Investigation and Treatment Options:

To visualize the tonsils and adenoids the physician will inspect the throat (with mouth open) and possibly use a small mirror or flexible scope to assess the size of adenoids. In the presence of infection, blood tests or throat cultures may be necessary to identify the type of infection. Sleep studies may be performed if there is a history of sleep disturbance in the presence of enlarged tonsils and adenoids.

Bacterial infections of these tissues are first treated with antibiotics. Frequent infections of the adenoids can cause infection to progress up the Eustachian tube (a tube linking the middle ear with the throat), causing middle ear infections especially in children. This may cause ear pain as well as temporary hearing loss. In situations of recurrent tonsil and adenoid infections, or in the presence of their persistent enlargement, removal of the tonsils (tonsillectomy) and/or adenoids (adenoidectomy) can often be performed as an outpatient surgical procedure in a hospital or surgicenter. Finally, in the rare event that a cancer or tumor is suspected, biopsy or other treatments may be warranted.

Tonsil and Adenoid Surgery for Children

When discussing this type of surgery with a child

  • Reassure your child that the procedure will make them healthier
  • Stay with your child as much as possible before or after surgery
  • Explain that a sore throat is common after surgery but medicine will help

Follow-up Care after Surgery

After surgery, starting in the recovery room, it is important for the patient to drink plenty of fluids to avoid dehydration. This becomes even more important in the 3 to 7 days following surgery, since discomfort in the throat may intensify. Also, post-operatively, vomiting and ear pain may occur, for which your doctor will recommend over-the-counter or prescription medication. Occasionally, persistent bleeding from the mouth or vomiting blood may occur – please notify your surgeon immediately.

If you or any of your family members have problems related to tonsils or adenoids, please call any of our offices to schedule an appointment with one of our board-certified ENT physicians.


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