Tonsils and adenoids: when is it necessary to remove them?

In the past, it was a very common intervention among children. Today, however, we tend to do it only in some cases. Let’s see why.

What are tonsils and adenoids?

The tonsils, or rather palatine tonsils, consist of lymphatic tissue. They have an egg-like shape and are located in the back of the mouth, at the side of the uvula.

Adenoids, also called pharyngeal tonsils, are also composed of lymphatic tissue and are located at the back of the nasal cavities.

What are they for?

During childhood, the tonsils and adenoids play a very important role in the child’s immune system: they protect the respiratory tract and complete the body’s immune defenses.

Also due to their strategic location for airway protection, these organs can be exposed to a large number of infections. Mostly these are viral phenomena, but in some cases they can also be bacterial.

Adenoviruses and rhinoviruses are the main culprits, while, among bacteria, streptococci cause most of the disorders.

When they become inflamed

Depending on whether the inflammation affects the tonsils or adenoids, the symptoms may be different:

Tonsillitis symptoms Adenoiditis symptoms
Difficulty swallowing Breathing difficulties
Enlargement and redness of the tonsils Hearing problems
Visible plaques on the mucous membranes that surround them Sleep apnea
Sore throat also severe Restless sleep
Presence of swollen glands in the neck Noisy breathing
Bad breath Breathing from the mouth
Fever Snoring
Nasal voice
Discharge from the nose associated with coughing
Ear infections

Once you have identified the agent that caused the infection, your doctor will suggest the most appropriate therapy.

When the disorder is of viral origin, it wears off spontaneously within 7-10 days. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be helpful to reduce discomfort.

In the case of bacteria, on the contrary, treatment with antibiotics may be indicated.

When they become a problem

How can a part of the body that helps defend us from infection become something “unwanted”?

Precisely because of their protective function, today we tend to perform a tonsillectomy, or a surgical removal of the tonsils, or an adenoidectomy, ie a removal of the adenoids, only in well-defined cases, contrary to what happened in the past.

In particular, the specialist could propose this solution in the event that the child is suffering from repeated tonsillitis (2 or 3 episodes per year, for 3 or more consecutive years).
In rare cases, irritated tonsils and adenoids can become excessively enlarged and cause breathing problems, especially during sleep.

The presence of enlarged adenoids can also lead to disorders in the ears, such as the appearance of recurrent otitis.

Also in these situations removal may be indicated.

A safe intervention?

Tonsillectomy is one of the most frequent interventions in children: it is therefore a safe procedure. The same applies to the removal of adenoids.

However, as with any surgical operation, it is always important to weigh the risks and benefits for possible complications related to surgery or anesthesia. It is in fact a procedure usually carried out under general anesthesia.

Removal of adenoids may be associated with improvement of rhinosinusitis symptoms and reduction of episodes of otitis media with the presence of phlegm in children over 3 years of age. Tonsillectomy, on the other hand, can promote the reduction or elimination of episodes of tonsillitis and the improvement of breathing.

After surgery, rest is recommended for a few days. In fact, annoyances such as:

  • sore throat
  • pain in the ears or when swallowing
  • vomit
  • fever
  • bad breath.

These are normal consequences of the surgical procedure and there is no need to be alarmed. In case of doubt, however, it is essential that you contact your trusted pediatrician.

Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.

The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.

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