Tonsils are pieces of lymphoid tissue located in the back of the mouth on both sides of the throat. The adenoid is a clump of tissue located behind the nasal cavity above the roof of the mouth where the nasal passages connect with the throat. Their main job is to help stop bacteria from getting farther down the throat. Since your tonsils and adenoid are part of your immune system, they do get bigger as your body fights off illnesses. Hypertrophy of the tonsils and the adenoids means this tissue is enlarged.
A child with enlarged tonsils and adenoids may have a sore throat, trouble swallowing, sleep apnea, and or ear infections. Obstructive sleep apnea, a condition indicated by pauses in breathing during sleep, can occur in severe cases of tonsil hypertrophy. This is due to the tonsils blocking the airway and where they stop breathing for a few seconds and then snort loudly to restart breathing. A test done overnight, called a sleep study can help determine if someone has sleep apnea by looking at these pauses during sleep.
Frequent ear infections can occur when enlarged tonsils and adenoids block the eustachian tubes and impede drainage. This can result in fluid build-up behind the eardrum and lead to ear infections.
When the tonsils become infected, that condition is known as tonsillitis. A sore throat is the primary symptom of tonsillitis. In addition to an overall sense of illness and fatigue, many patients report pain while swallowing and the presence of swollen neck glands. Some are able to see white spots at the back of their tonsils. Some people will never experience tonsillitis during their lifetime, while others will be plagued by the condition, especially during their younger years.
When you begin your consultation with your ENT physician, they will begin with a thorough review of your medical history. It is of great importance for your physician to understand what your tonsil related symptoms are, their duration, association with seasons or other environmental exposures (allergies, smoking, etc), as well as the full range of treatments that you have tried, for how long you have tried them, and their efficacy. A thorough physical exam will be performed including passing a small flexible camera (called a fiberoptic endoscope) through your nose and down the back of your throat to view your tonsils.
Some people experience recurring tonsillitis and will require a surgical procedure to remove their tonsils. Medical advancements have made tonsillectomy a relatively simple procedure with few adverse side effects and a low risk of complication. Tonsillectomies often reduce the occurrence of throat infections in the future and as well as remove the most current infection. In some cases, a tonsillectomy is performed if tonsils are so enlarged they impede breathing or swallowing. This procedure is much more common for children than for adults. The procedure takes only about 20 minutes, and many kids go home on the day of surgery. Recovery time is typically 1 to 2 weeks depending on the surgical technique used. Some pain can be expected and will affect eating and drinking for a short time.
An adenoidectomy is a surgical procedure to remove the adenoids. It is a simple, outpatient procedure with very few side effects. The adenoids are removed through the mouth without any external incisions. Recovery for most people is about 48 hours and the result is often significant relief of symptoms and complications.