Tonsils, which are found in the back of the throat, and adenoids, found in the back of the nose above the palate are like the sentries of your body’s immune system, alerting it to the presence of an invading virus or bacteria. As the first line of defense, they’re a sort of lymph node (albeit on the mucous membrane instead of under the skin) that is prone to infection, swelling, and difficulty swallowing or breathing.
Young children are more susceptible to infection of the tonsils (called tonsillitis) and adenoids than adolescents and adults because their immune responses are immature. Because the adenoids shrink with age and the body develops other ways to fight germs, infection becomes less common. However, adults can and do develop these infections.
Symptoms of enlarged adenoids and/or tonsils might include:
- Sore throat, sometimes with ear pain
- Bad breath
- Pain on swallowing
- Difficulty breathing and breathing through mouth instead of nose
- Change in voice (“hot potato” or “hyponasal” voice)
- Runny nose
- Nasal congestion
- Recurrent ear infections
Treatment is geared toward resolving the infection and reducing swelling. Typically, antibiotics with or without anti-inflammatory medications are prescribed. If infections are recurrent (more than 3/year for 3 or more years in a row) or the tonsils and adenoids remain enlarged, causing problems with breathing or recurrent ear infections, surgery to remove the enlarged tonsils and/or adenoids might be helpful.
A complication that may arise from tonsillitis is a bacterial infection called periotonsillar abscess. The main symptom of this type of abcess is painful swelling on one side of the mouth. Other symptoms include difficulty swallowing, sore throat, difficulty opening the mouth, chills, and earache. Usually a physical examination is enough to determine if you have a periotonsillar abcess. Antibiotics will be necessary, but often a needle aspiration or surgical drainage is also required to get rid of the collection of pus.
As both an otolaryngologist (an ear, nose, and throat doctor) and facial plastic surgeon, Dr. Yagoda of Manhattan, New York (NY) is able to offer her patients a full spectrum of treatment options. She can help you make lifestyle and dietary changes, and can develop a comprehensive treatment plan to relieve discomfort, restore free breathing, and prevent recurrence.