Surgical Removal of the Tonsils and Adenoids

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¿What are the tonsils and adenoids?

The tonsils are two lumps of tissue situated on both sides of the throat (see illustration right). They are mainly formed of unique cells that produce antibodies to fight infection. Each tonsil has various depressions on its surface which extend into the tonsil called "crypts". When we swallow the tonsils are squeezed together by throat muscles, and small amounts of food, viruses and bacteria enter the tonsils through the crypts triggering an immune response against viruses and bacteria.

The adenoids, located behind the nasal passage and on the soft palate, are also made up of cells that produce antibodies to fight infection (See image).

The adenoids process the foreign particles that are deposited when we breathe air through the nose and mouth. Therefore, adenoids are at increased risk for respiratory infection.

The adenoids and tonsils constitute a small portion of the human body immune system. Hence, the removal of adenoids or tonsils does not affect the general immune system.

¿What is tonsillitis or adenoiditis?


Tonsillitis or adenoiditis is the inflammation of the tonsils or adenoids usually caused by infection caused by a virus or bacteria. Common symptoms include sore throat, difficulty swallowing, bad breath, fever, swollen neck glands (lymph nodes), loss of appetite, changed voice, and feeling ill and tired. During infection, tonsils are swollen and red, and white or yellow pus usually comes from the pits on the surface of the tonsils.
We all have experienced tonsillitis at some point in our life. However, is us most common in young children as their immune system is yet not fully developed to fight the bacteria or virus causing the infection. Some patients develop recurrent or chronic infections which cause enlargement of the tonsils or adenoids. This could increase the risk of bad breath, abscess, sleep related breathing disorders, and in small children recurring ear problems, facial deformities, crooked teeth or stunted growth.

¿What is the treatment?

The treatment depends on the severity of the condition or symptoms, the number of episodes of tonsillitis, the response to the treatment and if there are underlying conditions which could put the patient's health at risk.
The decision of prescribing antibiotics should be done by a medical professional and should depend on the probability of a bacterial infection, since antibiotics are not effective against viruses. The use of antibiotics should be taken lately since the inconsiderate use of antibiotics causes antibiotic resistance. This means that the bacteria causing infection no longer respond to common prescribed antibiotics. Infections caused by antibiotic-resistant bacteria are challenging and sometimes impossible to treat.
Surgical removal of the tonsils or adenoids (tonsillectomy or adenoidectomy) is considered in cases of repeating and severe infection, which cannot be managed with medical treatment. Most patients are admitted to the hospital during the surgical treatment for one or two days, and recovery time is between two to three weeks.

The decision to have any surgical procedure should be after the surgeon knows all the patient’s medical history and has fully explained as well as discussed the surgical procedure, possible complications and risks.

* This information does not take the place of your doctor's advice. Please consult your healthcare provider for information about a specific medical condition.

References

Anmlsingh et al. (2018). Tonsillectomy and Adenoidectomy: Indications, Complications and their Management. Journal of Surgery: Open Access, 4(4). https://doi.org/10.16966/2470-0991.173 

Archer, S., Rosenfeld, R., Mitchell, R., & Baugh, R. (2010). Clinical Practice Guideline: Tonsillectomy in Children. Otolaryngology–Head and Neck Surgery, 143(2_suppl). https://doi.org/10.1016/j.otohns.2010.06.616 Ross, R., Milder, E., & Gerber, J. S. (2015).

Impact of a Clinical Practice Guideline on Antiboitic Use for Pediatric Tonsillectomy. Open Forum Infectious Diseases, 2(suppl_1). https://doi.org/10.1093/ofid/ofv133.997

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