Tonsils and Adenoids

What are tonsils & adenoids?

The tonsils and adenoids are lymphatic tissue similar to lymph nodes found in the neck and other parts of the body. Together they are part of a ring of glandular tissue (Waldeyer’s ring) encircling the back of the throat.

Tonsil Removal | Sore Throat Treatment | Vero Beach FL | Sebastian FL | Ft. Pierce FL The tonsils are the two masses of tissue on either side of the back of the throat. The adenoids are located high in the throat behind the nose and soft palate (roof of the mouth). Unlike tonsils, the adenoids are not easily visible through the mouth.

The tonsils and adenoids assist the body in defense against infection by “sampling” entering bacteria and viruses and becoming infected themselves. They then help form antibodies to resist and fight future infections. At times, however, they become more of a liability than an asset and may even trigger airway obstruction or repeated bacterial infections.

What is tonsillitis and how is it treated?

Tonsillitis is an inflammation of the tonsils, the fleshy areas at the back of the throat, and is caused by a virus or bacteria (e.g. streptococcus). It is generally spread through contact with throat or nasal fluids. The tonsils become swollen, red and may be coated with a yellow or white substance.

Although usually caused by a virus, tonsillitis can be a result of a bacteria and with either, symptoms may include:

  • Sore throat
  • Red, swollen tonsils
  • Difficulty swallowing
  • Fever
  • Headache
  • Swollen lymph nodes
  • Laryngitis

Dr. Lieberman may perform a rapid strep test and depending on the result, he might prescribe antibiotics along with drinking plenty of fluids, gargling with a warm salt water solution and mild pain medication (e.g. acetaminophen or ibuprofen).

Why are tonsils and adenoids surgically removed?

Tonsillectomy and adenoidectomy are considered for any of the following reasons:

  • Recurrent tonsil and/or adenoid infections that are resistant to treatment with medication or more than 3 or 4 infections per year for 2 years
  • Tonsil and/or adenoid enlargement causing upper airway/nasal obstruction (sleep apnea or difficulty breathing) or difficulty swallowing
  • Recurrent peritonsillar abscess (a painful collection of pus in the area of the tonsils)
  • Persistent foul taste or bad breath due to chronic tonsillitis and/or tonsilliths (stones in the depressions of the tonsils) not responsive to medications
  • Although rare, large tonsils could be a concern for a possible malignancy in adults
  • Chronic ear infections in children
  • Chronic rhinitis or chronic sinusitis

Dr. Lieberman performs the procedure in an outpatient surgery center. While under general anesthetic, the patient’s tonsils and adenoids are accessed through the mouth and are removed via laser. Dr. Lieberman has found that using a laser has been revolutionary in that patients have less bleeding, less trauma to surrounding tissue and decreased post-operative pain.

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Sore Throat (Pharyngitis)

Tonsil Removal | Sore Throat Treatment | Vero Beach FL | Sebastian FL | Ft. Pierce FL A sore throat is a symptom of many medical disorders including but not limited to cancer, “referred” pain from the sinuses or ears, infections (e.g. viral, bacterial, yeast), GERD (reflux), seasonal allergies, dry heat during winter months, excessive yelling, etc.

Home remedies for a sore throat

A mild sore throat associated with a cold or flu symptoms can be made more comfortable with:

  • Drinking more fluids…try tea with honey
  • Using a humidifier at night
  • Gargling with warm salt water (1 teaspoon of salt in 1 cup of water)
  • Take mild pain relievers such as ibuprofen or acetaminophen

When to seek medical care

Dr. Lieberman suggests that whenever a sore throat is severe, persists longer than the usual 5 to 7day duration of a cold or flu and is not associated with an avoidable allergy or irritation, you should make an appointment to be seen. Other symptoms indicating the need for an otolaryngologist include:

  • Severe and prolonged sore throat
  • Difficulty breathing
  • Difficulty swallowing
  • Difficulty opening the mouth
  • Joint pain
  • Earache
  • Rash
  • Fever (over 100.4*)
  • Blood in saliva or phlegm
  • Frequently recurring sore throat
  • Lump in neck
  • Hoarseness lasting over 2 week


Hoarseness refers to any abnormality of the voice and can manifest as changes in vocal characteristics resulting in a breathy, raspy, rough or strained quality with differences in projection or pitch.
Hoarseness from a cold or flu may be evaluated by family physicians, pediatricians, and internists. When hoarseness lasts longer than 2 weeks or has no obvious cause, it should be evaluated by an otolaryngologist (ear, nose and throat doctor). This is also true if the hoarseness is accompanied by coughing up blood, a lump in the throat or difficulty in swallowing.

How is hoarseness evaluated?

Dr. Lieberman will obtain a thorough history of the hoarseness and general health. He will examine the vocal cords with either a mirror placed in the back of the mouth or a very small, lighted flexible tube (fiber optic scope) is passed through the nose in order to view the vocal cords.

How is hoarseness treated?

The treatment of hoarseness depends on the cause. Most hoarseness can be treated by simply resting the voice or modifying how it is used. Dr. Lieberman may make some recommendations about voice use behavior or refer the patient to a speech pathologist. In some instances, he may recommend surgery to perform a biopsy if a lesion, such as a polyp or growth, is identified on the vocal cord. Avoidance of smoking or exposure to secondhand smoke is recommended to all patients. Drinking fluids and possibly using medications to thin the mucus are also helpful. Speech pathologists are trained to assist patients in behavior modification that may help eliminate some voice disorders. For example, a speech pathologist may teach patients to alter their method of speech production to improve the sound of the voice and to resolve problems, such as vocal cord nodules.