Adenoids and tonsils bolster immunity to infection and disease in the upper respiratory system. They play an important role in the health of young children by protecting them against disease yet that very “germ-trapping” function sometimes causes them to become “reservoirs1” of viruses and bacteria. As a result, the adenoids and tonsils can become easily, and repeatedly, infected. When that happens, an ear, nose, throat specialist (ENT) may recommend outpatient surgery to remove the adenoids and tonsils.

What are adenoids and tonsils?

Adenoids and tonsils have a lot in common.

The adenoids are glands that are located behind the nose and at the top of the roof of the mouth. Unlike the tonsils, you can’t see them when you open your mouth. The adenoids are made up of tissue that helps to catch and fight germs and bacteria as they pass through the mouth. They are most important in very young children, but their role and size shrink as children age.

Even though the adenoids contain antibodies that fight germs and bacteria, sometimes they absorb more than they can handle and become infected themselves. This is called adenoiditis. When the adenoids become infected they swell and can cause trouble breathing and swallowing. In some children, the adenoids become infected frequently, causing different symptoms that can include:

• Stuffy nose
• Pain in the ear and sometimes ear infections
• Sore throat
• Glands in the throat that swell
• Mouth breathing, snoring, difficulty sleeping

Adenoiditis can be treated with antibiotics. However, when a child begins to suffer symptoms frequently and/or has trouble breathing or sleeping, an ENT doctor may determine that it’s time to remove the adenoids. Called an adenoidectomy, the procedure is considered a common surgery and is performed on an outpatient basis. That means that most of the time, the child goes home the same day as the procedure. The tonsils may be removed at the same time as the adenoids, but that decision should be made in conjunction with your physician.

The tonsils are masses of tissue that work together with the adenoids to fight germs and bacteria. You can see them hanging down from the back of your throat when you open your mouth. Like the adenoids, the tonsils can become infected when they absorb too many germs. The infection is called tonsillitis and symptoms can include:

• Red, swollen tonsils
• Tonsils that have a white or yellow covering on them
• Sore throat (sometimes with ear pain)
• Swollen lymph nodes in the neck
• Throat infections like strep throat
• Fever
• Trouble sleeping
• Trouble breathing
• Bad breath (from the white/yellow covering that doesn’t smell very nice)

When to See a Doctor

If throat infections occur frequently (six2 or more times a year), if there’s a sore throat that doesn’t go away after 2 days, if there’s trouble breathing or sleeping, if a fever is higher than 103 degrees Fahrenheit, or there’s muscle weakness/neck stiffness, it’s time to consult your doctor.

Often tonsillitis can be treated successfully with antibiotics but a tonsillectomy may be recommended which, more than likely, would be performed on an outpatient basis. The doctor may even recommend removing the adenoids at the same time as the tonsils.

Although a parent never wants his or her child to have surgery, the good news is that the procedures to remove tonsils and adenoids are successful in addressing the symptoms of infection. Once the tonsil and adenoid tissue is removed it can no longer become infected and, as a result, sore throats, ear pain and breathing obstructions are greatly reduced if not eliminated altogether. If your child has repeated symptoms and is showing the signs of sleep disruptions, talk to your physician and discuss whether removing the tonsils and/or adenoids will provide your child with needed relief.

References
1: http://journals.sagepub.com/doi/abs/10.1177/03946320110240S401#
2: https://health.clevelandclinic.org/adenoids-tonsils-stay-go/