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.

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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