Tonsillectomy is the surgical removal of the tonsils, which are the paired glands located in the back of the throat. Although long practiced, the tonsillectomy is still one of the most common major surgeries in the US, with over 500,000 cases performed annually. Reasons to have a tonsillectomy tend to vary. The most common reasons include recurrent tonsil infections (tonsillitis) that don’t respond to antibiotics, sleep apnea, difficulty breathing or swallowing or concern for malignancy (cancer).
Having large tonsils does not necessarily indicate that surgery is needed. When the tonsils are so large that they are touching each other, they are considered “kissing tonsils”. Unless a patient experiences trouble breathing or difficulty swallowing, large tonsils that are not infected are usually observed. Sometimes this condition can be treated medically.
Recurrent tonsil infections (including streptococcal type infections) are very common in younger children. Symptoms typically include throat pain, difficulty swallowing, and enlarged lymph nodes. Under most circumstances, surgery should be considered after 5-7 infections in 1 year, 5 infections per year for two years in a row, or 3 infections per year for 3 years in a row. It should also be considered after missing a substantial amount of school or work (>2 weeks per year). Sometimes patients experience a severe infection in which an abscess develops on the tonsil, also known as a peritonsillar abscess (PTA). Tonsillectomy should be considered for patients who experience multiple PTA’s.
Sleep apnea is another indication for sleep apnea. Large tonsils (usually with enlarged adenoids) can obstruct the airway and cause difficulty breathing at night. By removing the tonsils ( and adenoids at times) patients may experience improved sleep quality, less snoring, and less daytime fatigue.This is a very common, effective treatment for children with pediatric sleep apnea.
If you or family members have concerns regarding tonsil or throat symptoms, please do not hesitate to contact Colden Ear, Nose, Throat, and Allergy to schedule an examination.
Tonsils are paired glands that are located in the back of the throat. Your tonsils are filled with nooks and crannies where bacteria, viruses, and other materials, dead cells, food particles and mucus, can become trapped. When this happens, the debris can become concentrated in white formations that occur in the pockets, known as tonsil stones (Tonsilloliths).
Tonsilloliths are formed when this trapped debris hardens, or calcifies. This tends to happen most often in people who have chronic swelling (inflammation) in their tonsils or repeated bouts of tonsil infections (tonsillitis). Usually tonsil stones form in adults and at times teenagers.
Often tonsilloliths do not cause any symptoms are simply a visible white, grey or discolored lump adjacent to the tonsil. Other times, one will develop irritation and redness at the site, and sometimes have a sensation of a lump in the back of the throat. Other symptoms include chronic sore throat, repeated infections, bad breath, and difficulty swallowing.
One of the most common remedies is gargling with salt water, which can dislodge these tonsil stones in many cases. Waterpick type of devices can “power wash” the tonsil stones away. In situations where the tonsil stones are causing more severe discomfort or continue to recur, one should speak with an Otolaryngology-Ear Nose Throat specialist about whether a course of oral antibiotics or surgical removal of the tonsils (tonsillectomy) is indicated.
Opinions expressed here are those of myself, Dr. Daryl Colden. They are not intended as medical advice and cannot substitute for the advice of your personal physician.
