Pediatric Tonsils & Adenoids

The tonsils and adenoids are part of the lymphatic system and serve as defenders of the immune system, protecting your body by preventing germs and bacteria from entering through your mouth and nose. Occasionally, they will develop problems themselves, requiring the attention of an ENT specialist. Infection of the tonsils and adenoids are common childhood illness, striking those between the ages of five and 15 most often.

The tonsils (located in the back of the throat) and adenoids (high in the throat, behind the nose and soft palate) work together to protect the body from illness – but sometimes fall prey themselves.

Tonsillitis is an infection of the tonsils that causes soreness and swelling. Affected tonsils appear red and may have white or yellow spots. Symptoms include sore throat, fever, bad breath, ear pain, swollen lymph nodes in the neck and difficulty swallowing. Younger children may experience drooling and exhibit marked irritability and a refusal to eat. Surgical removal of the tonsils (tonsillectomy) was a common practice in the past, but now doctors prefer to treat the condition with antibiotics first. If a patient is subject to chronic tonsillitis, a tonsillectomy (and often an adenoidectomy, as well) may be recommended.

Enlarged tonsils and adenoids can also block the airways and cause soreness, ear infections and breathing difficulties. Side effects include runny nose, snoring and sleep apnea. Steroid treatment is sometimes helpful, but in many cases, enlarged tonsils and adenoids need to be removed surgically.

Your child’s doctor will check for tonsillitis and adenoiditis through a physical exam and a close-up inspection of the throat, ears and nose with a lighted instrument known as an otoscope. A throat swab to test for strep is usually performed at the same time.

Home care is beneficial in relieving the symptoms of a tonsil or adenoid infection and aiding in a speedier recovery. Make sure your child gets plenty of rest and liquids; warm broth or tea with honey as well as cold Popsicles can help soothe the throat. Gargling with warm saltwater several times a day may also help. If your child is older than four, sucking on lozenges can help relieve a sore throat. Use a humidifier to moisten the air, or have your child sit in a steamy bathroom for a few minutes. Pain and fever can be treated with over-the-counter medications such as ibuprofen and acetaminophen, but refrain from giving your child aspirin, as this has been linked to a rare but life-threatening illness called Reye’s syndrome.

When strep throat or another bacteria is the cause of your child’s tonsil or adenoid infection, antibiotics are prescribed. Make sure your child takes the full dose of antibiotics, even if the infection has cleared up. This prevents a rebound in symptoms.

Surgical removal of the tonsils and/or adenoids is nowhere near as common as it was in the past. While still an option, a tonsillectomy or adenoidectomy is usually reserved for severe or recurring cases of infection.

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