Two studies done on adults and children found patients reported less infections, bad breath, sore throats and trips to the doctor after undergoing tonsillectomies.
While more rare in adults, tonsillectomies are one of the most common surgeries performed on children each year. Doctors recommend them for people with three or more tonsil infections in a year’s time.
Dr. Brett Parkinson with Mountain Medical explains who this procedure is right for…and some additional benefits you could experience.
A generation or two ago, tonsillectomy and/or adenoidectomy was such a common operation that it was almost considered routine. Imagine that: A routine surgery! A couple of nasty bouts of tonsillitis and children were whisked off to the operating room, only to wake up a few hours later to excruciating pain and a bowl of jell-o–the only thing they could eat until their throats healed. One general practitioner who was interviewed for this segment indicated that up until the 1970’s, “A Tonsillectomy and Adenoidectomy would be performed for the flimsiest of medical excuses: minimally swollen or inflamed tonsils, asthma, bronchitis, recurrent colds or even failure to thrive.” It was if the procedure were a rite of passage for the average elementary school student. But as time went on, and research suggested the operation was often needlessly performed, fewer physicians were willing to subject children to what was becoming regarded as a potentially risky undertaking. Not only do the tonsils serve as part of the immune system, protecting our children from common infections, serious bleeding can occur with their removal. For those reasons, doctors are much less likely to perform the procedure now than they were when our parents and grandparents were coming of age. However, there are still medically sound indications for removal of the tonsils and adenoids. But the list of those indications is far more restrictive than it was in the past. And whereas the surgery used to be performed by general practitioners, it is now the domain of specialized ENT surgeons.
WHAT ARE THE TONSILS AND ANDENOIDS?
• They are masses of tissue similar to lymph nodes found elsewhere in the body, such as the neck, groin or armpits. Together they form a ring of tissue that encircles the back of the throat. (Show color graphic of AP and lateral view of anatomy.) The tonsils are the two masses at the back of the throat. Normally, they are symmetrical in size and pinkish in color, just like the surrounding tissue. On their surface there are little depressions, called crypts. The adenoids are located higher in the throat, just behind the nose and roof of the mouth.
WHAT FUNCTION DO THE TONSILS AND ADENOIDS SERVE?
• They are part of the immune system, helping the body in its defense against bacteria and viruses, mostly in the first year of life. Until the body’s more sophisticated immune system develops, they function as the front-line guardians of infection. Medical studies have shown, however, that children who have had tonsils and/or adenoids removed suffer no significant loss in immune function later in life. As children grow, the tonsils begin to shrink and their importance to immunity diminishes as well.
WHAT ARE THE COMMON PROBLEMS AFFECTING THE TONSILS AND ADENOIDS?
• Infection caused by bacteria and viruses
SYMPTOMS OF TONSILLITIS:
• Redder than normal tonsils
• A white or yellow coating on the tonsils
• A slight voice change due to swelling
• Sore throat
• Uncomfortable or painful swallowing
• Swollen lymph nodes (glands) in the neck
• Bad breath
Chronic tonsillitis can lead to the formation of small crypts or pockets in the tonsils, an ideal place for bacteria to proliferate. In addition, small stones can form within the crypts, causing the sensation of something being caught in the back of the throat. One of the dreaded complications of tonsillitis is abscess formation. When this occurs, it pushes the tonsils toward the uvula, leading to excruciating pain and decreased ability to open the mouth. If left untreated, the infection can spread to other areas in the neck and may even lead to life-threatening airway obstruction.
SYMPTOMS OF ENLARGED ADENOIDS:
• Mouth Breathing
• Recurrent ear infections
• Noisy breathing during the day
• Snoring Sleep apnea
HOW IS TONSILLITS AND ANDOID INFECTION TREATED?
• When the infection is bacterial, the treatment is antibiotics. If it is caused by streptococcus bacteria, which can lead to serious complications, it must be expeditiously treated. If suspected, the diagnosis can be confirmed by a throat culture or rapid-strep test in the doctor’s office.
• Viral infections are treated only with supportive care (hydration and fever control). Antibiotics are not effective for viral tonsillitis.
• Abscesses must either be drained with a needle or incised with a scalpel.
WHEN IS SURGERY INDICATED?
• Repeated or persistent infections, especially if they interfere with everyday activities. Repeated infections are defined as six to seven episodes per year, four to five episodes in each of two years, or three episodes in each of three years. A significant bout of tonsillitis includes a fever greater than 101, pus formation, enlarged or tender lymph nodes in the neck or a positive strep test.
• Persistent mouth-breathing
• Abnormal speech
• Severe snoring or sleep apnea
• Heart failure
• Persistent swallowing difficulties
• Recurrent abscesses
Surgery is not indicated for merely enlarged tonsils, recurrent colds or viral sore throats, recurrent strep throats (daily penicillin for six months will often taken care of chronic strep, obviating the need for surgery) or recurrent ear infections.
IF SURGERY IS NECESSARY, WHAT ARE THE RISKS?
• Approximately 4% of children bleed on the fifth to eight post-op days. Some may even require blood transfusion or additional surgery.
• Small risk of death: 1 child per 250,00 operations
• A small percentage of children may develop hyper nasal speech, due to failure of the soft palate to close completely.
ABOUT MOUNTAIN MEDICAL PHYSICIAN SPECIALISTS
Mountain Medical Physician Specialists is a partnership of over 50 board-certified radiology and vascular professionals providing patients along the Northern Wasatch Front with the latest imaging and vascular care available. Mountain Medical professionals specialize in vascular surgery, vascular and interventional radiology, CT, neuroradiology, orthopedic imaging, MRI, women’s imaging, ultrasound, nuclear medicine and body imaging. For more information visit www.mtnmedical.com.