Written by Dr. Emily Savoca
What are tonsils?
Tonsils are mounds of lymphatic tissue that live in the back of the throat. They are part of the immune system, which helps the body fight infections. The “tonsils” that we usually talk about look like two balls on each side at the back of the throat. There is also tonsil tissue along the back of the tongue, which is less commonly a cause for concern. The adenoids are also made of tonsil tissue but live at the back of the nose.
Tonsil size and sleep issues
Big tonsils are not always a problem. Sometimes, enlarged tonsils can cause breathing issues during sleep, ranging from snoring to obstructive sleep apnea. Obstructive sleep apnea means that the airway becomes partially blocked during sleep. In children, this is usually due to large tonsils and adenoids. Symptoms of sleep apnea include snoring, coughing or choking while sleeping, waking up frequently throughout the night, bed-wetting, daytime hyperactivity and issues with behavior. It is important to remember that not all snoring is sleep apnea.
If there is a concern about sleep apnea and your child has large tonsils or adenoids, surgery might be recommended. In some cases, your doctor may want a sleep study first, which can help differentiate snoring and sleep apnea. Snoring alone is not necessarily an issue, but sleep apnea is, as it affects development and overall health.
Infections
Tonsillitis is an infection of the tonsils and is very common. Symptoms include fevers, enlarged tonsils, sore throat, and swollen lymph nodes in the neck. Most infections are from viruses and do not need to be treated with antibiotics. With viral tonsillitis, it is more common to have a cough and runny nose. Bacterial tonsillitis, often “strep throat,” does need to be treated with antibiotics. If your child suffers from recurrent strep tonsillitis, surgery to remove the tonsils may be considered.
What about the adenoids?
Since the adenoids are at the way back of the nose, you cannot see them through the mouth. Either an x-ray or a camera through the nose is needed to see the adenoids. Sometimes, the adenoids can be enlarged or chronically infected even when the tonsils are not.
Surgery to remove the adenoids carries less risk and is an easier recovery than tonsil surgery. For this reason, if a child needs to have their tonsils out, the adenoids are usually removed at the same time. Some children, however, may need their adenoids out but not their tonsils.
Tonsil stones
Tonsil stones are white bits of debris that can develop in the crevices of tonsil tissue. They can cause bad breath and irritation but are not dangerous. Brushing the teeth frequently and oral hygiene can help prevent them. Gargling with salt water can also help dissolve existing stones. If causing irritation, a stone can be removed. Surgery is not usually recommended for this issue alone.
Surgery
Surgery to remove the tonsils is called a tonsillectomy, and surgery to remove the adenoids is called an adenoidectomy. The tonsils and adenoids are often removed at the same time. The surgery is performed under general anesthesia, meaning your child will be completely asleep. Surgery usually takes less than an hour. Many children can go home afterwards but some need to be monitored overnight in the hospital.
Sore throat is expected after surgery. Recovery takes 1-2 weeks in most children, though teenagers and adults can have a sore throat for several weeks after. It is very important to stay hydrated during the recovery period, and pain medications can help make drinking fluids a little easier.
There is a risk of bleeding after tonsillectomy.
There is no significant risk of increased infections afer removing the tonsils and adenoids even though they are part of the immune system. In fact, the frequency of sore throat and sinusitis should improve after surgery.
Tonsillectomy can make a big difference for children experiencing tonsil issues such as sleep apnea and recurrent tonsillitis. However, surgery is not right for everyone. Remember, big tonsils aren’t always a problem. If you have concerns about your child’s tonsils and want them examined, schedule time with an ENT physician today at Advanced Specialty Care. We have offices in Danbury, New Milford, Ridgefield & Norwalk, and same-day appointments may be available. Book your appointment now by calling us or requesting online today.
– Dr. Emily Savoca
Emily Savoca, MD is an ENT surgeon specializing in the treatment of pediatric patients, with over a decade of clinical & medical research experience. Emily’s most recent publications & presentations have discussed pediatric listening devices, obstructive sleep apnea, tonsillectomies, and sinusitis. Emily served for three years as the resident liaison for Yale’s Otolaryngology Residency Committee, and she is a member of the American Academy of Otolaryngology, American Society of Pediatric Otolaryngology, and the American Medical Association. Emily Savoca, MD sees pediatric & adult patients in our Danbury & Norwalk offices.
ADVANCED SPECIALTY CARE
Advanced Specialty Care Ear, Nose & Throat and Head & Neck Specialists are recognized as some of the region’s top ENT Physicians. Call (203) 830-4700 to schedule an appointment with a Specialist at any of our convenient offices in Danbury, New Milford, Norwalk and Ridgefield, CT.
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