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Tonsillectomy & Adenoidectomy

The tonsils and adenoid play an important role during childhood as a major defense system against infections in the upper respiratory tract. The tonsils are lymphoid tissues located in the back and on each side of the throat. The adenoid tonsil is also made up of lymphoid tissue and is located in the upper back part of the throat behind the nose. They work together to “catch” and trap incoming infections. Unfortunately, the tonsil and adenoid may become the source of infection itself like a plugged filter.

Each upper respiratory infection stimulates the tonsils and adenoid to enlarge to fight the next infection. Children now socialize at such a young age (daycare, preschool, etc), they develop more infections when the immune systems are still immature and their airways are still small. This all contributes to the increased incidence of tonsils and adenoid enlargement at younger ages relative to their throat size than in the past. Usually tonsils and adenoids only begin to gradually shrink in size after 12 years of age. By this age near complete facial and dental growth has occurred.

Tonsillectomy and adenoidectomy is the most commonly performed major surgical procedures in children. It is recommended for children with any of the following signs and symptoms:

• Adenoid and/or tonsil enlargement (hypertrophy)
• Upper airway obstruction (snoring, nasal congestion, chronic mouth breathing, restless sleeping, daytime tiredness or sleep apnea)
• Chronic or recurrent throat infections requiring antibiotics (not necessarily strep throat)
• Dental and facial growth abnormalities from chronic mouth breathing (crossbite, open bite, high arched palate, facial elongation)
• Peritonsillar abscess

Adenoidectomy alone is often recommended for children with:

• Recurrent or chronic sinusitis
• Recurrent middle ear infections
• Chronic middle ear fluid with hearing loss
• Adenoid enlargement (hypertrophy) in very young children when tonsillectomy is not an option yet

Numerous medical studies have definitively proven that removal of the tonsils and adenoids is helpful for the above problems without resulting in any negative impact on the immune system. Fortunately, there is ample other lymphoid tissue still remaining in the throat to perform its immune function (i.e., lingual tonsils on the back of the tongue, accessory tonsils on the back wall of the throat, Gerlach tonsils near the Eustachian tube opening, etc).