Tonsils: tonsillitis, tonsil stones and tonsillectomy
Tonsils are small, modified clusters of lymph node-type tissue. They are part of an abundance of lymph tissue on all the internal linings of the body. These tissues contain immune cells that are part of the body’s surveillance system, which is known as mucosa-associated lymphoid tissue.
What do tonsils do?
Tonsils are the first line of defence against infections that enter your body through the mouth and nose. The immune cells in the tonsil and adenoid area take up proteins and particles that have been ingested either by eating, breathing or nasal secretions. They show these proteins and particles to your immune system to allow your body to know what sort of pathogens or bacteria or viruses are present in the environment, and trigger the production of antibodies to fight these infections.
What issues can tonsils develop?
Despite evolving to protect your health, in some cases, tonsils can become a medical problem. They can cause obstruction by taking up too much room in the breathing system so you are choking, gasping or having snoring and breathing problems. Tonsils can cause problems with eating: some children really struggle with their gag reflex and struggle to be able to breathe well while they are eating due to large tonsil size. Tonsils can also become chronically infected and dysfunctional, and if they are a source of chronic infection or recurrent strep throat, they can become more harmful than helpful.
What is tonsillitis?
Tonsillitis is a bacterial infection where the bacteria overgrow, causing the tonsils to become swollen, very sore, red and covered in pus exudate.
What are the symptoms of tonsillitis?
Tonsillitis usually presents with fevers and chills associated with a very sore throat, usually in the absence of a cough or other viral symptoms.
Is tonsillitis contagious?
Tonsillitis can be caused by very contagious viruses such as infectious mononucleosis or by Streptococcus, which is a bacteria that is transmissible by kissing, sneezing or touching.
How can you treat tonsillitis?
Tonsillitis is often treated with antibiotics, although the evidence is that antibiotics do not do much to reduce the duration or severity of symptoms. Pain from tonsillitis can be managed with simple painkillers, a modified diet and adequate rest. When tonsils are very swollen and sore, they can respond well to oral steroid medications prescribed by a general practitioner or Dr McKenzie.
What happens if you or your child keeps getting tonsillitis?
If you or your child is experiencing severe or recurrent episodes of tonsillitis, the best treatment is removal of the tonsils.
Enlarged or inflamed tonsils
While tonsillitis is the most common reason for tonsils to become enlarged, they can also swell due to allergies or chronic irritation. Enlarged tonsils cause problems such as difficulty breathing through the mouth, snoring, and sleep disturbances. They can also make swallowing uncomfortable and lead to frequent throat infections.
How do you treat tonsil issues?
The impact on your quality of life needs to be weighed against the outcome of any treatment that your ENT recommends. Unfortunately, topical treatments, gargles and washes are not particularly effective. Tonsillitis can respond to antibiotics but not very well, and there are significant risks to your general immune system by repeated exposure to antibiotics. If the number and severity of episodes of tonsillitis or of sleep problems due to enlarged tonsils become significant enough to impact on someone's quality of life, then Dr McKenzie would treat these problems with a tonsillectomy – removal of tonsils – and can discuss with you what the right technique is in that situation.
Tonsillectomy
Dr McKenzie will discuss with you the best approach to treating you or your child's tonsil problems. This procedure can be done as a day case but often requires an overnight stay for some nursing support. The recovery involved is a minor sore throat but it is still slow, and Dr McKenzie will prescribe medications that help with the recovery. She practises a specific regimen which leads to an earlier return to function and reduces days off work, school or childcare. Dr McKenzie works with her anaesthetist to make sure that you are as comfortable as possible in the post-operative period.
Further information about tonsil surgery
Where does Dr McKenzie operate?
Dr McKenzie operates at Brisbane Private Hospital in Spring Hill, Mater Children's Private Hospital/Mater Private Hospital in South Brisbane, and Greenslopes Private Hospital in Greenslopes for both paediatric and adult patients.
These hospitals all offer excellent paediatric nursing care support, and Dr McKenzie only uses specialist paediatric anaesthetists for your child’s procedure. This means that you can be assured that your child is in the safest possible hands as it takes a dedicated and comprehensive team of specialist nurses and doctors to safely provide paediatric ear, nose and throat surgery. Dr McKenzie has chosen these hospitals based on their ability to provide the highest level of care to your child.
For adult patients, Dr McKenzie selected these hospitals due to their access to intensive care units and the most modern facilities and resources to ensure the best experience for your procedure.
Are there alternatives to surgery?
A tonsillectomy is generally the best treatment for tonsil problems. Antibiotics are not particularly effective in treating tonsillitis, and if tonsillitis recurs, then the risk of frequent antibiotic use needs to be weighed up against the risk and potential benefits of a tonsillectomy.
What are the risks of surgery versus the risk of not removing the tonsils?
While all surgeries carry some risks, these are well understood and carefully managed by specialist doctors and nurses. It’s important to remember that leaving a chronic condition untreated can lead to worsening health problems that may become more difficult to treat over time. Dr. McKenzie will only recommend surgery when the expected benefits clearly outweigh the potential risks.
What’s the difference between tonsils and adenoids?
“Adenoids” is the name that is given to the deposit of tonsil tissue deep behind the nose, whereas the term “tonsil” is commonly used to describe the palatine tonsils, which are the tonsils on the side of your throat behind your teeth. There are also lingual tonsils and many hundreds of deposits of tonsil tissue throughout the throat. The palatine tonsils that are removed for the treatment of snoring and sleep-disordered breathing are the most commonly known. There is no difference in function between tonsils and adenoids: both protect your body from infection.
Adenotonsillectomy: do adenoids and tonsils need to be removed together?
In the care of children and the treatment of sleep-disordered breathing, tonsils and adenoids almost always need to be removed together. This procedure is called an adenotonsillectomy. The only indication for removing tonsils without removing the adenoids is in adults with adenoids that have regressed and are no longer present, or in tonsillitis where there is no problem being caused by the adenoids.
Can tonsils grow back?
It is very rare for tonsils to grow back after a complete tonsillectomy. In the case of coblation intracapsular adenotonsillectomy, the tonsils have a regrowth rate of approximately 5%. Up to 1% of children may go on to have another operation to remove tonsils in the future.