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The tonsils are in the back of the throat (oropharynx), and the adenoids are located just above the tonsils, in the back of the nose (nasopharynx). They serve to filter germs from the oral and nasal environment, by trapping germs as they enter the mouth and nose. Enlargement or recurrent infections of the tonsils and adenoids are common in children and sometimes adults, and are often responsible for several symptoms such:

  • Sore throats
  • Chronic or recurrent sinusitis
  • Snoring
  • Obstructive sleep apnea
  • Difficulty swallowing (dysphagia)
  • Nasal Congestion
  • Ear pain
  • Bad breath (halitosis)

Enlarged tonsils and adenoids can cause blockage of the nose and mouth, which leads to snoring and/or disruptive breathing while sleeping (apnea).  Whether large or small, the tonsils and adenoids can harbor bacteria that continually block or infect the sinuses, which leads to chronic or recurrent sinusitis.  Since the tonsils and adenoids play a minimal role in our immune system, removing them has no affect on an individual’s overall health.

Causes:

  • Recurrent infections
  • Enlarged tonsils and adenoids
  • Cancers
  • Peritonsillar abscess (infection around or behind the tonsil)
  • Family history

Diagnosis:

  1. Comprehensive History:
    Your physician should understand your individual history including previous treatments and a family history of similar problems.  Recurrent or chronic problems with tonsils and adenoids should be discussed with your primary doctor and an ENT (Ear, Nose, Throat) specialist.
  2. Physical Examination:
    The tonsils and can be directly viewed in the office during your consultation.  The grading system for the size of the tonsils is based on a scale from 1 (smallest) to 4 (largest).  The adenoids can’t be seen directly like the tonsils because they are in the very back of the nose (nasopharynx), and are usually visualized using a nasal endoscope.  The adenoids are graded by the amount of blockage, or obstruction, that they cause to the back of the nose.
  3. Nasal Endoscopy:
    A tiny camera is used to visualize the tonsil and adenoid tissue, and the amount of nasal and oral obstruction that they may cause.  This is a simple and painless procedure that is performed in the office during your consultation.A tiny camera is used to visualize the tonsil and adenoid tissue, and the amount of nasal and oral obstruction that they may cause.  This is a simple and painless procedure that is performed in the office during your consultation.
  4. CT (CAT) scan:
    This is a specialized X-ray used to visualize the tonsil and adenoid tissue, especially if they are causing other related problems, such as sinus disease (sinusitis).  CT scans are also needed to evaluate the extent of disease in patients that may have a suspicion or diagnosis of tonsil or adenoid cancer.  This test is quick, painless, and is done digitally so you can review the results with your physician in the office.

Treatment:

  1. Medication:
    Antibiotics are used to treat infected tonsils and adenoids.  Sometimes, an anti-inflammatory steroid is used to help reduce the swelling and pain of severely inflamed, or swollen, tonsils and adenoids.  Although antibiotics and steroids are effective for a single infection, recurrent episodes and continuous (chronic) infections are usually treated surgically.
  2. Surgery:
    Removal of the tonsils and adenoids is performed under general anesthesia at an accredited surgery center or hospital.  The procedure takes approximately 15-20 minutes and patients typically go home on the same day of surgery (outpatient).  Postoperative discomfort and healing time is approximately 1 week.
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