Oftentimes, your tonsils and adenoids are talked about together. Your tonsils are in the back of your throat and adenoids are in the back of the nasal cavity. They both serve a very important purpose, as tonsils and adenoids are the body’s first line of defense as part of the immune system. They sample bacteria and viruses that enter the body through the mouth or nose, but they sometimes become infected, leaving you in pain.
At times, they become more of a liability than an asset and may even cause airway obstruction or repeated bacterial infections. Your favorite ENT specialist from Oklahoma Otolaryngology Associates can suggest the best treatment options to get you feeling well.
What are tonsils and adenoids?
Tonsils and adenoids are similar to the lymph nodes or glands which are found in the neck, groin and armpits. Tonsils are the two round lumps in the back of the throat. Adenoids are high in the throat behind the nose and the roof of the mouth (soft palate) and are not visible through the mouth or nose without special instruments.
What affects tonsils and adenoids?
The two most common problems affecting the tonsils and adenoids are recurrent infections of the nose and throat, and significant enlargement causes nasal obstruction and/or breathing, swallowing and sleep problems.
Abscesses around the tonsils, chronic tonsillitis and infections of small pockets within the tonsils that produce foul-smelling white deposits can also affect the tonsils and adenoids, making them sore and swollen. Cancers of the tonsil, while uncommon, require early diagnosis and aggressive treatment.
When should I see a doctor?
You should see your doctor when you or your child experiences the common symptoms of infected or enlarged tonsils or adenoids. Your physician will ask about problems of the ear, nose and throat and examine the head and neck.
Other methods used to check tonsils and adenoids are:
Physical examination
Throat cultures/Strep tests – helpful in determining infections in the throat
X-rays – helpful in determining the size and shape of the adenoids
Blood tests – helpful in diagnosing infections such as mononucleosis
Sleep study is sometimes helpful in determining whether sleep disturbance is occurring because of large tonsils and adenoids
Tonsillitis and its symptoms
Tonsillitis is an infection of the tonsils. One sign is swelling of the tonsils. Other symptoms are:
White or yellow coating on the tonsils
A slight voice change due to swelling
Sore throat, sometimes accompanied by ear pain
Uncomfortable or painful swallowing
Swollen lymph nodes (glands) in the neck
Fever
Bad breath
Enlarged tonsils and/or adenoids and their symptoms
If you or your child’s adenoids are enlarged, it may be hard to breathe through the nose. If the tonsils and adenoids are enlarged, breathing during sleep may be disturbed. Other signs of adenoid and or tonsil enlargement are:
Nose sounds blocked when the person speaks
Chronic runny nose
Noisy breathing during the day
Recurrent ear infections
Snoring at night
Restlessness during sleep, pauses in breathing for a few seconds at night (may indicate sleep apnea).
How are tonsil and adenoid diseases treated?
Bacterial infections of the tonsils, especially those caused by streptococcus, are first treated with antibiotics. Removal of the tonsils (tonsillectomy) and/or adenoids (adenoidectomy) may be recommended if there are recurrent infections despite antibiotic therapy and/or difficulty breathing due to enlarged tonsils and/or adenoids. Such obstruction to breathing causes snoring and disturbed sleep that leads to daytime sleepiness and may even cause behavioral or school performance problems in some children.
Chronic infections of the adenoids can affect other areas such as the Eustachian tube, which is the passage between the back of the nose and the inside of the ear. This can lead to frequent ear infections and buildup of fluid in the middle ear that may cause temporary hearing loss. Studies also find that removal of the adenoids may help some children with chronic earaches accompanied by fluid in the middle ear (otitis media with effusion).
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 infectious mononucleosis, severe enlargement may obstruct the airway. For those patients, treatment with steroids is sometimes helpful.
HOW TO PREPARE FOR SURGERY
Children
Encourage the idea that the procedure will make him/her healthier
Be with your child as much as possible before and after the surgery
Explain to your child to expect a sore throat after surgery and that medicines will be used to help the soreness
Reassure your child that the operation does not remove any important parts of the body and that they will not look any different afterward
It may be helpful to talk about the surgery with a friend who has had a tonsillectomy or adenoidectomy
Your otolaryngologist can answer questions about the surgical procedure
Adults and Children
For at least two weeks before any surgery, the patient should refrain from taking aspirin or other medications containing aspirin. (WARNING: Children should never be given aspirin because of the risk of developing Reye’s syndrome). Your doctor may ask you to stop taking other medications that may interfere with clotting.
A blood test may be required prior to surgery.
A visit to the primary care doctor may be needed to make sure the patient is in good health at surgery.
You will be given specific instructions on when to stop eating food and drinking liquids before surgery. These instructions are extremely important, as anything in the stomach may be vomited when anesthesia is induced.
When the patient arrives at the hospital or surgery center, the anesthesiologist and nursing staff may meet with the patient and family to review the patient’s history. The patient will then be taken to the operating room and given an anesthetic. Intravenous fluids are usually given during and after surgery.
After the operation, the patient will be taken to the recovery area. Recovery room staff will observe the patient closely until discharge. Every patient is unique, and recovery time may vary.
Your ENT specialist will provide you with the details of preoperative and postoperative care and answer your questions.
After surgery
There are several postoperative problems that may arise. These include not being able to swallow, vomiting, fever, throat pain and ear pain. Occasionally, bleeding from the mouth or nose may occur after surgery. If the patient has any bleeding, your surgeon should be notified immediately. It is important to drink liquids after surgery to avoid dehydration.