The tonsils are located on both sides of the back of the throat. The adenoids are located higher and further back, where the nasal passages connect with the throat. Tonsils and adenoids have a role in helping the body fight infection. Tonsils are visible through the mouth, but the adenoids are not. Hypertrophy means enlargement. Hypertrophy of the tonsils and the adenoids means this tissue is enlarged. Adenoid hypertrophy is common in children but rare in adults. The common causes of adenoid hypertrophy in adults are chronic infection and allergy. Pollution and smoking are also important factors that can contribute to tonsil and adenoid hypertrophy.
In some cases of enlarged tonsils and adenoids there are no apparent symptoms. However, when tonsil hypertrophy is more severe, children typically experience symptoms for example:
The voice may be altered slightly because of swollen tissue near the vocal chords.
Swallowing certain foods may become difficult if the enlarged tissue of the tonsils becomes obstructive.
Children may eat less and lose their appetite if swallowing food is difficult or painful.
Halitosis (bad breath) can occur because of infections of the tonsils.
Snoring because of obstruction to the airway from the enlarged tonsils.
Obstructive sleep apnea, a condition indicated by pauses in breathing during sleep, can occur in severe cases of tonsil hypertrophy. This is due to blocked airways and is a serious condition.
Frequent ear infections when enlarged tonsils block the Eustachian tubes and impede drainage. This can result in fluid build up behind the eardrum and ear infections.
Chronic Sinusitis if the swollen tonsils and surrounding tissue prevent proper drainage from the sinus cavities. The mucous becomes trapped and infections can develop. Symptoms such as congestion, pressure and fatigue are common with sinusitis
An ENT doctor has specialized training in infections, diseases, and conditions of the ear, nose, and throat. Your ENT will most likely perform a physical examination to determine where the infection is located. They will also ask about your family history to determine if your condition is hereditary.
Usually, to view the back of the nose and throat, doctors insert a flexible viewing tube through the nose (called a nasopharyngoscope). Doctors also look for redness of the tonsils, enlargement of lymph nodes at the jaw and in the neck, and the effect of the tonsils on breathing.
Other tests can include:
Throat examinations using swabs to obtain samples of bacteria and other organisms
Blood tests to determine the presence of infections such as mononucleosis
X-rays of your head and neck to determine the size of your adenoids and extent of infection
Sometimes the enlarged tissue shrinks on its own or as the child grows, and no treatment is needed. If severe tonsil hypertrophy is not treated however, serious health conditions can result. Underlying infections can spread to other areas of the body, and untreated streptococcus bacteria (strep throat) can even damage the kidneys and heart valves.
Medication and surgery can be used to treat tonsil hypertrophy. When infection is the cause of tonsil hypertrophy, antibiotics can be effective. Once the infection is cleared, the enlarged tonsil tissue typically returns to normal size. If antibiotics do not work or if enlarged tonsils and adenoids cause problems with breathing and sleeping, surgery may be the best treatment option. The tonsils can be removed through a surgical procedure known as a tonsillectomy.
A tonsillectomy is a simple and effective surgery. The surgeon removes the tonsils through a child's mouth without any external incisions in the skin. The procedure takes only about 20 minutes, and many kids go home the day of surgery. Recovery time is typically 1 to 2 weeks depending on the surgical technique used. Some pain can be expected and will affect eating and drinking for a short time. By removing the enlarged tonsils, the obstruction is cleared, and symptoms are eliminated in most cases.
An adenoidectomy is a surgical procedure to remove the adenoids. It is a simple, outpatient procedure with very few side effects. The adenoids are removed through the mouth without any external incisions. Recovery for most children is about 48 hours and the result is often significant relief of symptoms and complications.