Nowadays, many young children had their tonsils already removed. Tonsils removal or surgery process is called tonsillectomy. In fact, surgery was once the standard treatment for tonsillitis, which is an inflammation of the tonsils caused by a viral or bacterial infection. Tonsillectomy was commonly done in preschool and school-age children, since they are most affected with tonsillitis. However, we all had chance to hear that in some cases children's behavior and sleep improved after they had a tonsillectomy. Among the children, in the study who had attention deficit hyperactivity disorder (ADHD), before the surgery, half of them did not have it a year after their tonsils were removed. The question is how could we know which solution is better, alternative or tonsillectomy procedure?
Tonsillitis
The fact is that doctors today are much less likely to recommend removal of the tonsils. It could be the reason that tonsillitis often can be treated effectively with home care or antibiotics. It's known that tonsils are specialized lymph nodes on either side of the throat, which are normal part of the body's immune system. Tonsils help filter out harmful bacteria and viruses that could cause more serious infections. If treated with appropriate antibiotics, the symptoms of bacterial tonsillitis should disappear in just a few days, so surgery is generally considered only if tonsillitis affects your child's breathing or swallowing, or if the condition reoccurs often. It is important to know after the children in the study group had their tonsils out, tests showed little difference between them and the children in the comparison group. The results appear to support previous research suggesting a link between children's sleep-related breathing problems and daytime behavior problems. However, these findings do not prove cause and effect, and that tonsillectomy is not usually a cure for ADHD.
Tonsils and Adenoids
Tonsils and adenoids are masses of tissue that are similar to the other lymph nodes in our organism. These lymph nodes or glands are found in the neck, groin, and armpits. Tonsils are the two masses on the back of the throat, while adenoids are high in the throat behind the nose and the roof of the mouth, which is known as soft palate.
Adenoids are not visible through the mouth without special instruments. Tonsils and adenoids are placed near the entrance to the breathing passages where they can catch incoming germs that causes infections. Since they sample bacteria and viruses, they can become infected themselves. Scientists believe they work as part of the body's immune system by filtering germs that attempt to invade the body. Their role is to develop antibodies to germs that invade human organism. This happens primarily during the first few years of life, becoming less important as we get older, so children who must have their tonsils and adenoids removed suffer no loss in their resistance.
What Affects Tonsils and Adenoids?
The most common problems affecting the tonsils and adenoids are recurrent throat or ear infections. Beside this, it is common problem with 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. This is making tonsils and adenoids sore and swollen. However, tumors are rare, but can grow on the tonsils as well.
When the doctor’s exam is needed?
You should see your doctor when you or your child suffers the common symptoms of infected or enlarged tonsils or adenoids, so the doctor could examine them right away. The primary methods used to check tonsils and adenoids are medical history, physical examination, throat cultures or strep tests, X-rays and blood tests. During the exam your doctor will ask about problems of the ear, nose and throat, and examine the head and neck. He or she will use a small mirror or a flexible lighted instrument to see these areas to get you right diagnosis. Cultures or strep tests are important in diagnosing certain infections in the throat, especially streptococcus throat. X-rays are sometimes helpful in determining the size and shape of the adenoids, while 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, but sometimes, removal of the tonsils or adenoids will be recommended. The two primary reasons for tonsil and/or adenoid removal are recurrent infection despite antibiotic therapy and difficulty breathing due to enlarged tonsils and/or adenoids. Such obstruction to breathing problems, causes snoring and disturbed sleep, which leads to daytime sleepiness in adults and behavioral problems in children. Some orthodontists believe chronic mouth breathing from large tonsils and adenoids causes malformations of the face and improper alignment of the teeth, which is interesting to hear. Problem is what chronic infection can affect other areas such as the eustachian tube, which can lead to frequent ear infections and potential hearing loss. Some recent studies indicate adenoidectomy may be a beneficial treatment for some children with chronic earaches accompanied by fluid in the middle ear. In adults, the possibility of cancer or a tumor may be another reason for removing the tonsils and adenoids known as tonsillectomy and adenoidectomy.
Symptoms of tonsillitis
Tonsillitis is an infection in one or both tonsils, so one of the signs is swelling of the tonsils. Other signs or symptoms are redder than normal tonsils, white or yellow coating on the tonsils, slight voice change due to swelling, and most commonly sore throat. When patient is complaining about uncomfortable or painful swallowing, swollen lymph nodes or glands in the neck, fever, or bad breath, he or she should visit the doctor.
Causes of tonsillitis
As previously explained, tonsils are a pair of specialized lymph nodes located on either side of the throat, just behind and above your tongue and they're part of your body's immune system. We know that helps protect our organism from microorganisms that can cause infection. Tonsils store white blood cells to engulf bacteria and viruses as they enter through your nose and mouth, so when bacteria and viruses are engulfed by white blood cells, which may result a low-grade infection in your tonsils. This minor infection then stimulates your body's immune system to form antibodies. However, your tonsils may be overwhelmed by a bacterial or viral infection, and they swell and become inflamed, so the final result is tonsillitis. A number of respiratory viruses can cause tonsillitis, including the Epstein-Barr virus (EBV), which is the same virus that can cause mononucleosis. Some strains of bacteria also can cause tonsillitis, but the most common culprit is the same bacterium that causes an infection of the throat commonly known as strep throat, known as Streptococcus pyogenes, or group A beta-hemolytic streptococcus.
Symptoms of enlarged adenoids
If you or your child's adenoids are enlarged, it may be hard to breathe through the nose, but there are more symptoms as well. Common symptoms of constant enlargement are breathing through the mouth instead of the nose most of the time. These patients also have nose sounds blocked when the person speaks, noisy breathing during the day, recurrent ear infections, and snoring at night. It could also happen that breathing stops for a few seconds at night during snoring or loud breathing, which is known as sleep apnea.
Surgery For Tonsils and Adenoids
Surgery for tonsils and adenoids is called tonsillectomy and adenoidectomy. The first report of tonsillectomy was made by the Roman surgeon Celsus in 30 AD, and he described scraping the tonsils and tearing them out or picking them up with a hook and excising them with a scalpel. Today, the scalpel is still the preferred surgical instrument of many ear, nose, and throat specialists, but there are other procedures available. The choice may be dictated by the extent of the procedure, or complete tonsil removal versus partial tonsillectomy, and other considerations such as pain and post-operative bleeding. When doctor decide your child should have tonsillectomy or adenoidectomy, you should talk to your child about his/her feelings. You should also provide strong reassurance and support throughout the process.
It is important to encourage the idea that the procedure will make him/her healthier, and you should be with your child as much as possible before and after the surgery. The patient can expect a sore throat after surgery, so you shall reassure your child that the operation does not remove any important parts of the body, and that he/she will not look any different afterward. It is important to know that for at least two weeks before any surgery, the patient should refrain from taking aspirin or other medications containing aspirin. It’s very important that children should never be given aspirin, because of the risk of developing Reye's syndrome. If the patient or patient's family has had any problems with anesthesia, the surgeon should be informed about it, before surgery starts. If the patient is taking any other medications, has any therapy or any disease, surgeon should be informed. Beside this, a blood test and possibly a urine test may be required prior to surgery. It is important to know that nothing should be eaten, because anything in the stomach may be vomited when anesthesia is induced, and this could be very dangerous and life threatening.
After surgery is done
After the operation of tonsillectomy and adenoidectomy is done, the patient will be taken to the recovery area. Recovery room staff will observe the patient until discharged, because every patient is special, and recovery times vary for each individual. Many patients are released after 2–10 hours, while others are kept overnight. In some cases intensive care may be needed. There are several postoperative symptoms that may arise, which include, but are not limited to swallowing problems, vomiting, fever, throat pain, and ear pain. Occasionally, bleeding may occur after surgery, so if the patient has any bleeding, surgeon should be notified immediately. It is also recommended that after operation, it's important to drink fluids when you wake up. You should try to drink, even if it hurts a bit at first, because this will help you feel better and get home faster.
