Tonsillitis and How to Know When Your Child Has It

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As a kid, I had lot of throat infections.  I was used to taking antibiotics and missing school pretty frequently.

Finally, after I had been dealing with nagging infections for an extended period of time, my doctor informed my mother that I would need to have my tonsils removed because of my tonsillitis.

My doctor explained that a tonsillectomy would be necessary because they weren’t doing their job very well. In my case, my adenoids were not infected or enlarged, so they stayed where they were.

What are tonsils and adenoids? What is their job?

Tonsils are small, round clumps of lymph tissue located in the back of the mouth on both sides of your throat.

Adenoids are also clumps of lymph tissue that are located where the back of your nose meets your throat, near your breathing passages. They both help fight infections. 

When there is a throat infection, you can get inflamed tonsils/adenoids (tonsillitis or adenoiditis) "tonsil or adenoid" and "itis" meaning inflammation.

Symptoms of Tonsillitis

Even without the benefit of years of medical experience, parents can keep an eye out for certain tonsillitis symptoms.

I am lucky to have a mother who is a nurse. However, even without the benefit of years of medical experience, parents can keep an eye out for these symptoms in their children. If you notice your child is experiencing the following symptoms, take them to their pediatrician or an ear, nose and throat specialist for an examination.

  • Sore throat
  • Fever
  • Not wanting to eat or swallow
  • Not feeling good in general
  • Pain when swallowing
  • Redness or swelling in the throat when you look (usually easiest to see with a flashlight)

In the majority of cases, viruses are the most common cause of tonsillitis. The second most common cause is a bacteria known as Streptococcus (Group A Beta hemolytic Streptococcus), otherwise known as "strep throat." Other bacteria can cause tonsillitis, but much less frequently.

Symptoms of Adenoid inflammation or Hypertrophy

  • Mouth breathing
  • Noisy breathing
  • Snoring sounds when sleeping
  • Speech that sounds nasal in tone

Most Common Reasons for Getting a Tonsillectomy or Adenoidectomy

A boy opens his mouth to have his throat examined.If your child is diagnosed with tonsillitis and/or adenoiditis, their pediatrician may recommend a tonsillectomy and/or adenoidectomy. The part “ectomy” means that something is being surgically removed.

In about 80 percent of the cases, the surgery is recommended to resolve an upper-airway obstruction.

Upper Airway Obstruction (UAO)

This is when the tonsils and/or adenoids are large enough to partially block the airway, making normal breathing nearly impossible. This condition is diagnosed by a doctor during his/her examination and by the patient’s medical history.

Obstructive Sleep Apnea (OSA)

This is a more severe form of UAO, which causes breathing to actually stop temporarily while the person is sleeping. This can happen one or two times, or many times during sleep. 

This condition causes the oxygen level in the blood to drop and can manifest in sleepiness during the day, restlessness, irritability and  possibly even poor performance in school. It can also cause other medical problems.

OSA, if suspected, is diagnosed by a sleep study, in addition to the doctor’s exam and the child’s history. The Division of Pulmonology at Children's Hospital Los Angeles has has a family-friendly four-bed sleep laboratory staffed by licensed therapists, nurses, and technicians. Visit their page on Pulmonology Treatment Programs for more information.

Other Possible Reasons

While these are the most common reasons a tonsillectomy would be recommended, there are still others that a pediatrician might take into consideration.

  • Tonsillar or adenoid hypertrophy (tissue overgrowth)
  • Tonsillitis occurring repeatedly over time (there are guidelines, but they differ region to region and doctor to doctor, practice to practice, etc.)
  • Adenoiditis causing inner-ear infections and/or a blocked airway (again, guidelines vary)
  • Children who would clearly benefit from the tonsillectomy due to their symptoms

Stay Tuned

Many medical advances have taken place since I had my tonsillectomy back at the tender age of 5. Did you know that these days, the procedure usually takes less than 15 minutes? I'll talk more about my personal experience as well as what tonsillectomy patients can expect these days in my next post.