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Chronic Tonsil and Adenoid Infections

When to con­sid­er surgery

Each year, more than half a mil­lion chil­dren in the Unit­ed States under­go surgery to remove their ton­sils and ade­noids. Ton­sils and ade­noids are made up of lym­phoid tis­sue and are locat­ed at the back of your child’s nasal pas­sage. Ton­sils and ade­noids help to pre­vent ill­ness­es by trap­ping and fil­ter­ing harm­ful bac­te­ria that enters your child’s body dur­ing activ­i­ties like breath­ing, eat­ing or swallowing.

Ton­sils and ade­noids play a large role in keep­ing infants and small chil­dren healthy, but become less impor­tant as their bod­ies devel­op oth­er ways to fight germs. Around the age of five, ton­sils and ade­noids begin to shrink, and are almost com­plete­ly gone by the time your child reach­es their teenage years.

As germs and bac­te­ria are trapped, ade­noid tis­sue can become swollen and cause symp­toms including:

  • Noisy or dif­fi­cult breath­ing through the nose
  • Snor­ing
  • Dis­rupt­ed breath­ing dur­ing sleep­ing (obstruc­tive sleep apnea)
  • Sinus symp­toms
  • Recur­ring infec­tions or flu­id accu­mu­la­tion in the mid­dle ear

Ton­sils can also become enlarged or infect­ed when your child is exposed to res­pi­ra­to­ry virus­es, strep throat or mononu­cle­o­sis (mono). Inflam­ma­tion of the ton­sils, or ton­sil­li­tis, caus­es a vari­ety of symp­toms including:

  • Sore throat
  • Cough­ing
  • Headaches
  • High fevers
  • Painful swal­low­ing
  • Vis­i­ble white spots or pus on the tonsils

Although it is uncom­fort­able ini­tial­ly, swelling of the ton­sils and ade­noids typ­i­cal­ly resolves on its own after about a week. In some cas­es, if the swelling per­sists, ton­sils may become infect­ed. If your child’s doc­tor sus­pects an infec­tion, your child’s ears, nose and throat will be exam­ined and a small tele­scope is often used to obtain a clos­er view of their nasal pas­sage. If an infec­tion is found, antibi­otics and nasal steroids are often prescribed. 

Some chil­dren may expe­ri­ence chron­ic infec­tions or swelling of their ton­sils and ade­noids. In these cas­es, it may be time to con­sid­er surgery if your child is expe­ri­enc­ing one or more of the following:

  • Dif­fi­cul­ty breathing
  • Sleep dis­rup­tion includ­ing obstruc­tive sleep apnea
  • Chron­ic infec­tions (sinus, ear or ton­sil and ade­noid infections)
  • Recur­rent accu­mu­la­tion of flu­id in the mid­dle ear or hear­ing loss requir­ing ear tubes
  • Infec­tions aren’t respond­ing to antibiotics
  • Fre­quent­ly miss­ing school or oth­er activities

In many cas­es, ton­sils and ade­noids are removed at the same time, espe­cial­ly if your child expe­ri­ences fre­quent sore throats or infec­tions, or infec­tions that cause an abscess, puss or swelling behind the ton­sils. Remov­ing ton­sils and ade­noids helps to alle­vi­ate many of the asso­ci­at­ed symp­toms, and can have a sig­nif­i­cant impact on chil­dren who expe­ri­ence obstruc­tive sleep apnea as a result of the chron­ic inflam­ma­tion in their nasal pas­sage. Sleep plays an impor­tant role in child­hood devel­op­ment, your child’s behav­ior and their over­all health. Remov­ing the ton­sils and ade­noids can cor­rect obstruc­tive sleep apnea, improv­ing the qual­i­ty of sleep, your child’s mood and their abil­i­ty to per­form activ­i­ties through­out the day. 

Surgery to remove ton­sils and ade­noids is usu­al­ly done under gen­er­al anes­the­sia, usu­al­ly does not require stitch­es, typ­i­cal­ly can be done in under an hour and your child will be able to go home the same day. Your child may expe­ri­ence some dis­com­fort in their mouth or ears fol­low­ing the pro­ce­dure that gen­er­al­ly lasts about a week, and in most cas­es, the throat is healed with­in about 10 to 14 days.

If your child suf­fers from recur­ring sore throats, enlarged ton­sils or ade­noids or fre­quent infec­tions, espe­cial­ly those that cause oth­er symp­toms like obstruc­tive sleep apnea or dif­fi­cul­ty breath­ing, you should con­sult with an oto­laryn­gol­o­gist (ENT) to find out if surgery is rec­om­mend­ed. To sched­ule an appoint­ment with one of our ENT spe­cial­ists vis­it dupagemed​ical​group​.com/​s​e​r​v​i​c​e​s​/​o​t​o​l​a​r​y​n​g​o​logy/.