Did you know...
Almost 400,000 tonsillectomies and/or adenoidectomies are performed each year in the U.S.-the second most common operation for children.
What Are Tonsils and Adenoids?
Tonsils and adenoids are composed of tissue that is similar to the lymph nodes or "glands" found in the neck, groin, and armpits. The adenoids are high in the throat behind the nose and soft palate (room of the mouth) and, unlike tonsils, are not visible through the mouth without special instruments. The tonsils are the two masses of tissue on either side of the back of the throat.
Tonsils and adenoids are strategically located near the entrance to the breathing passages where they can catch incoming germs, which cause infections. They "sample" bacteria and viruses and can become infected themselves. Scientists believe they function as part of the body's immune system by filtering germs that attempt to invade the body and developing antibodies to germs or "invaders". They are not our only source of lymphocytic tissue in our body, resisting and fighting infection.
This function is performed in the first few years of life, becoming less important as we get older. One recent study showed that children who must have their tonsils and adenoids removed suffer no loss whatsoever in their future immunity to disease.
What should I Expect at the Exam?
The primary methods used to evaluate tonsils and adenoids are:
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Medical history
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Physical examination
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Throat cultures
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X-rays
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Blood tests
Your physician will take a history of the patient's ear, nose, and throat problems and examine the head and neck. Examination of the nose and throat may be aided by the use of small mirrors or a flexible, lighted instrument.
Cultures are important in diagnosing certain infections in the throat, especially "strep" throat. Whether or not a culture is taken will depend on your physician's judgement and the physical appearance of the throat.
X-rays are sometimes helpful in determining the size and shape of the adenoids.
In children, the most common problems affecting the tonsils and adenoids are recurrent infections (sore throats or ear infections) and significant enlargement or obstruction (which causes breathing and swallowing problems). Both also occur in adults.
Abscesses, chronic tonsillitis, and infections of small pockets (crypts) within the tonsils that produce bad smelling, cheesy-like formations can also affect the tonsils and adenoids, making them sore and swollen.
Tumors are rare, but can grown on the tonsils. Recent studies indicate adenoidectomy may be beneficial treatment for some children with chronicotitis media with effusion (earaches accompanied by fluid in the middle ear).
What diseases affect tonsils and adenoids?
When should I contact my doctor?
You should see your doctor when you or your child suffer the common symptoms of infected or enlarged tonsils or adenoids: recurrent sore throats, tender swollen neck nodes, fever, chills, bad breath, nasal obstruction, recurrent ear infections, mouth breathing, snoring, and sleep disturbances.
Treating Diseases of the Tonsils and Adenoids...
Bacterial infections of the tonsils, especially those caused by streptococcus, are treated initially with antibiotics. Removal of the tonsils, and/or adenoids may be recommended for some children and adults. The two primary reasons for tonsil and/or adenoid removal are (1) recurrent infection despite antibiotic therapy and (2) difficulty breathing due to enlarged tonsils and/ or adenoids. Obstruction to breathing causes snoring and disturbed sleep patterns that lead to daytime sleepiness in adults and behavioral problems in mouth beathing from large tansiles and adenoids causes malformations of the face and improper alignment of the teeth. Chronic infection in the tonsils and adenoids can affect nearby structures such as the eustchian tube-teh passage between the back of the nose and the inside of the ear. This can lead to frequent ear infections and potential hearing loss.
In adults, the possibility of cancer or a tumor may be another reason for removing the tonsils and adenoids. In some patients, especially those with infections mononucleosis, severe enlargement may progress to a point of obstructing the airway. For those patients, treatment with steroids (e.g., cortisone) is sometimes helpful.
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