Tonsils and Adenoids: A Different Perspective

Health

Dr. Kaustabh Kalita

“T&A” (short for Tonsillectomy and Adenoidectomy) is the second most common operation performed for children, and it is not unusual for an adult to require a tonsillectomy. Although T&A is not recommended as often as before the days of antibiotics, it is still a valuable operation that improves the health of many children and adults.

Recent studies indicate that Adenotonsillectomy may be beneficial treatment for some young children affected by chronic otitis media with effusion (fluid in the ears).

What Is the Purpose of Tonsils and Adenoids?

Tonsils and adenoids are composed of tissue that is similar to the lymph nodes or “glands” found in the neck, groin, and other places in the body. They are part of a “ring” of glandular tissue encircling the back of the throat. The adenoids are located high in the throat behind the nose and soft palate (roof of the mouth) and, unlike tonsils, are not visible through the mouth without special instruments. The tonsils are the two masses of tissue on either side of the back of the throat.

Tonsils and adenoids are strategically located near the entrance to the breathing passages where they can catch incoming infections. They ‘sample” bacteria and viruses and can become infected themselves. It is thought that they then help form antibodies to those “germs” as part of the body’s immune system to resist and fight future infections.

This function is performed in the first few years of life, but it is less important as the child gets older. In fact, there is no evidence that tonsils or adenoids are important after the age of three. One recent large study showed, by laboratory tests and follow-up examinations, that children who must have their tonsils and adenoids removed suffer no loss whatsoever in their future immunity to disease.

There is a popular myth that tonsils and adenoids filter bacteria out of what we swallow and breathe, somewhat like a kitchen strainer. This is untrue. Any filter that could strain out microscopic bacteria would not allow the passage of any food particles and would make eating impossible.

How Does the Doctor Check Tonsils and Adenoids?

The primary methods that are used to evaluate tonsils and adenoids include:

Your physician will take a history about the patient’s ear, nose, and throat problems and perform an examination of the head and neck.

Examination of the nose and throat may be aided by the use of small mirrors or a flexible lighted instrument. The physical examination will also determine whether the lymph nodes in the neck are enlarged.

X-rays are sometimes helpful in determining the size and shape of the adenoids. These x-rays are quite safe.

What Diseases Affect Tonsils and Adenoids?

The most common problems affecting the tonsils and adenoids in children are recurrent infections (causing sore throats) and significant enlargement (causing trouble with breathing and swallowing). Recurrent acute infections of the tonsils also occur in adults. So do abscesses around the tonsils, chronic tonsillitis, and infections of small pockets (crypts) within the tonsils that produce bad smelling, cheesy-like formations.

When Should I Consult My Doctor?

You should see your doctor when you or your child suffer the common symptoms of infected and enlarged tonsils and adenoids: Recurrent sore throats, fever, chills, bad breath, nasal congestion or post-nasal drainage or obstruction, recurrent ear infections, mouth breathing, snoring, and sleep disturbances.

How Are Diseases of the Tonsils and Adenoids Treated?

Bacterial infections of the tonsils, especially those caused by ‘’Strep,’’ are initially treated with antibiotics.

Removal of the tonsils and/or adenoids may be recommended for some children and adults. The two primary reasons for tonsil and/or adenoid removal are (1) recurrent infection despite antibiotic therapy and (2) difficulty breathing due to enlarged tonsils and/or adenoids. Obstruction to breathing causes snoring and disturbed sleep patterns that lead to daytime sleepiness in adults and behavioral problems in children. Some orthodontists believe chronic mouth breathing from large tonsils and adenoids causes malformations of the face and improper alignment of the teeth.

Chronic infection in the tonsils and adenoids can also affect nearby structures such as the eustachian tube - the passage between the back of the nose and the inside of the ear. This can lead to frequent or chronic ear infections with earaches and hearing loss.

Coblation tonsillectomy and adenoidectomy is a gentle procedure for removing both tonsils and adenoids offering a fast and easy recovery. Traditional methods remove tonsils and adenoids by cutting or burning, which can cause extensive pain and damage to surrounding healthy tissue. Coblation is an advanced technology that combines gentle radiofrequency energy with a natural salt solution to quickly and safely remove tonsils and adenoids. The innovative approach of Coblation results in minimal pain, bloodless field and rapid recovery for patients.

(Dr Kaustabh Kalita has done his MBBS and DLO from Assam Medical College (Dibrugarh) and went on to complete his DNB from KKR ENT Hospital & Research Institute (Chennai). After completion of DNB, he was working as a senior consultant at KKR ENT Hospital (Kilpauk, Chennai) and later on promoted as Consultant in Charge of KKR ENT Superspeciality Hospital (Maduravoyal, Chennai). After almost 10 years of extensive experience in the field of Otorhinolaryngology, he has now joined as Chief consultant - ENT and Head & Neck Surgery, Ayursundra Superspecialty Hospital in Guwahati)