Tonsil
and adenoid disorders

What affects tonsils and adenoids?
The most common problems affecting the tonsils and adenoids are recurrent infections (throat or ear) and significant enlargement or obstruction that causes breathing and swallowing problems.

Abscesses around the tonsils, chronic tonsillitis, and infections of small pockets within the tonsils that produce foul-smelling, cheese-like formations can also affect the tonsils and adenoids, making them sore and swollen. Tumors are rare, but can grow on the tonsils.

When should I see my doctor?
You should see your doctor when you or your child suffer the common symptoms of infected or enlarged tonsils or adenoids.

The primary methods used to check tonsils and adenoid:
  • Medical history
  • Physical examination
  • Throat cultures/Strep tests
  • X-rays
  • Blood tests

What should I expect at the exam?
Your physician will ask about problems of the ear, nose, and throat and examine the head and neck. He will use the small mirror or a flexible lighted instrument to see these areas. Cultures/strep tests are important in diagnosing certain infections in the throat, especially "strep" throat. X-rays are sometimes helpful in determining the size and shape of the adenoids. Blood tests can determine problems such as mononucleosis.

How are tonsil and adenoid diseases treated?
Bacterial infections of the tonsils, especially those caused by streptococcus, are first treated with antibiotics. Sometimes, removal of the tonsils and/or adenoids may be recommended. The two primary reasons for tonsil and/or adenoid removal are (1) recurrent infection despite antibiotic therapy and (2) difficulty breathing due to enlarged tonsils and/or adenoids.

Such obstruction to breathing causes snoring and disturbed sleep that leads to daytime sleepiness in adults and behavioral problems in children. Some orthodontists believe chronic mouth breathing from large tonsils and adenoids causes maliformations of the face and improper alignment of the teeth.
Chronic infection can affect other areas such as the eustachian tube-the passage between the back of the nose and the inside of the car. This can lead to frequent ear infections and potential hearing loss.

Recent studies indicate adenoidectomy may be a beneficial treatment for some children with chronic earaches accompanied by fluid in the middle ear (otitis media with effusion).

In adults, the possibility of cancer or a tumor may be another reason for removing the tonsils and adenoids. In some patients, especially those with infectious mononucleosis, severe enlargement may obstruct the airway. For those patients, treatment with steroids (e.g., cortisone) is sometimes helpful.

Tonsillitis and its symptoms:
  • Redder than normal tonsils
  • A white or yellow coating on the tonsils
  • A slight voice change due to swelling
  • Sore throat
  • Painful Swallowing
  • Swollen lymph nodes in the neck
  • Fever
  • Bad breath
Enlarged Adenoids and their Symptoms:
  • Breathing through the mouth instead of the nose most of the time
  • Nose sounds "blocked" when the person speaks
  • Noisy breathing during the night
  • Recurrent ear infections
  • Snoring at night
  • Breathing stops for a few seconds at night during snoring or loud breathing (sleep apnea)

Provided by the American Academy of Otolaryngology