Tonsils and tonsillectomy — Mr Daniel Tweedie. The tonsils, like the adenoids, tend to be very small in babies, but grow significantly in toddlers and pre- school children. They are usually smaller by adolescence and adulthood, but may sometimes remain large.
Almost 400,000 tonsillectomies and/or adenoidectomies are performed each year in the United States. "T&A" (short for tonsillectomy and adenoidectomy) is the second.
Adenoid removal is surgery to take out the adenoid glands. The adenoid glands sit behind your nose above the roof of your mouth in the nasopharynx.
We believe that the tonsils are important in the developing immune system in infants, but they probably have little benefit after about two or three years of age. In reality, the tonsils may need to be removed for a number of reasons, sometimes even in very young children, and there is no strong evidence that this makes any difference to children’s long term immunity to infections. What problems can the tonsils cause?
The main problems requiring treatment are obstruction to breathing and sore throats (tonsillitis). There are also some less common ways in which the tonsils cause problems. Breathing problems. The tonsils may be quite prominent compared to the size of the throat, particularly in young children who have relatively small throats and relatively large tonsils. Tonsils may therefore create difficulties with breathing by physically obstructing the airway, particularly at night. When we sleep, our muscle tone reduces and we become floppy. The muscles in the soft tissues around the throat (soft palate, and tongue base) also become floppy, causing the airway of the throat to collapse a little.
If the tonsils are also large, the airway becomes even more cramped and restricted, leading to snoring and even obstructive sleep apnoea. Sore throats and tonsillitis. Sore throats are very common, particularly among children. These are most often caused by cold viruses, but bacteria are also sometimes involved (particularly in more severe cases, with high fever).
The throat becomes generally red and inflamed. During these spells, the tonsils may also look red and inflamed, just like the rest of the throat, particularly in young children. This does not necessarily mean tonsillitis. If the infection becomes worse, blebs of pus may appear on the surface of the tonsils, and we call this tonsillitis.
This may result in severe pain, difficulties swallowing and high fever. Other complications can also sometimes arise, including an abscess around the tonsil (a quinsy) and fever- related problems (such as febrile convulsions). A form of tonsillitis may also occur in glandular fever. Peri- tonsillar abscess (quinsy)Occasionally, tonsillitis may lead to severe inflammation and soft tissue swelling around the tonsil. A collection of pus may form, as the body tries to fight off the infection. This is called a peri- tonsillar abscess, or quinsy.
This scenario is more common in adolescents and adults than in young children. A quinsy will often need to be drained to release the pus. This can be done through the mouth in the clinic, with a local anaesthetic. High dose antibiotic treatment will usually allow things to settle within a day or two. Repeated quinsy is another reason why the tonsils might require treatment. Glandular fever. This is relatively common in adolescents and young adults, and is caused by a virus transmitted in saliva (Epstein- Barr virus, or EBV). A variety of the body’s systems may be involved.
Tonsillitis is common, usually with a white film coating the tonsils, rather than the smaller pustules in typical tonsillitis. The lymph glands of the neck will also often flare up. The liver and spleen may also become inflamed and enlarged.
The GP or ENT doctor should therefore examine the abdomen if glandular fever is suspected, and contact sports should be avoided for at least six weeks, in case a blow to the abdomen causes damage to the liver or spleen. A simple blood test will often confirm the diagnosis, but is not always reliable. Otherwise, treatment is generally supportive: plenty of rest, simple painkillers, fluid and food. Alcohol should be avoided. Cheap Vacation Packages Adults Only here. Antibiotics are not usually helpful; in any case, avoid amoxicillin (on its own or in other preparations), as this can cause a nasty rash.
Admission to hospital is sometimes necessary. Debris in the tonsils (“tonsil stones”) and bad breath. The little pits in the tonsils may accumulate bacteria and food particles, which some people find uncomfortable or smelly. Careful tooth brushing and use of mouthwashes will often help, so that removal of the tonsils for this reason alone is not usually recommended. Feeding difficulties and drooling. Large tonsils at the back of the throat may occasionally make swallowing difficult for children, and may also make drooling more likely if the saliva is hard to swallow. Again, these problems are not usually bad enough on their own to justify removal of the tonsils. Asymmetrical tonsils and growths within the tonsils.
Unequal- looking tonsils are quite common. In reality, the apparent asymmetry usually results from one of the tonsils swinging out more than the other when the throat is examined.
Enlarged tonsils and adenoids can negatively impact speech because they interfere with the proper flow of air and affect resonance and the quality of your voice. Tonsillitis — Comprehensive overview covers symptoms, treatment for this common cause of sore throat in children. Tonsils and Adenoids Insight into tonsillectomy and adenoidectomy. What affects tonsils and adenoids? When should I see a doctor? Common symptoms of tonsillitis and.
Fact sheet: Tonsils and adenoids. American Academy of Otolaryngology — Head and Neck Surgery. http:// Accessed June 1, 2015. Tonsils, Adenoids, Throat Infections and Sleep Apnea. What are tonsils? What are adenoids? How do tonsils and adenoids affect sleep? What is the difference between. Indications for Tonsillectomy and Adenoidectomy. Generally, there are two reasons why a child may need tonsils or adenoids removed. Most patients believe the most.