Removal of the tonsils and adenoids are among the most common surgical procedures performed by doctors among children. Approximately one-fourth of all children will have their tonsils removed. In fact, more and more children undergo removal of their tonsils in the recent years and expected to increase in the near years to come. Because children frequently suffer more sore throats and earaches when the tonsils and adenoids become inflamed, it is important to understand when they should be appropriately removed before serious complications ensue.
The tonsils and adenoids are lymph glands, located in the back of the throat and nose. They protect the body from local infections caused by viruses and bacteria. They also produce antibodies that combat infection throughout the rest of the body.
Inflammation of the tonsils may result in sore throat, difficulty in swallowing, earache or fever. Occasionally, their enlargement creates difficulties with breathing, especially in infants and younger children.
Children between the ages of two and nine years are the ones who frequently suffer from enlarged adenoids. Sometimes they are associated with allergies or colds. The condition may result in mouth breathing, ear infections, chronic hearing problems, speech disorders, snoring, or impaired growth of the teeth and jaws.
Infections of the tonsils and adenoids usually respond well to adequate treatment with antibiotics. Children who have three or more episodes of tonsillitis per year with accompanying fever and enlarged, tender lymph glands in the neck, or who have strep throat, should be considered for tonsillectomy. Rarely, tonsillar enlargement affects the heart, which prompts an early removal.
Some physicians (usually pediatricians) may feel that a tonsillectomy should be performed for other reasons, including repeated episodes of tonsillitis despite the use of antibiotics. Abscesses of the tonsil may also prompt early removal.
If a child’s speech is severely distorted from enlargement of the adenoids, removal should be considered. In addition, adenoidectomy may be of value in treating children with recurrent ear infections who have problems with speech and who exhibit significant hearing losses. In those children with persistent fluid in the ear caused by blockage of the Eustachian tubes from adenoidal enlargement, it may even be necessary to remove the fluid and insert a small tube in the eardrum.
Statements to the effect that tonsils and adenoids should “always be removed” or “never be removed” are incorrect. There are specific reasons for performing tonsillectomies and adenoidectomies, either together or separately and the decision will be based from thorough evaluation and past medical histories of the child. More so, if a child has problems with frequent sore throats and earaches, or has difficulty with speech and hearing, he should be examined by a physician for advice concerning the most suitable methods of treatment for these problems.
