What is the symptoms of tonsillitis? Is it painful to get your tonsils removed?

Tonsils and Adenoids

The tonsils face each other from opposite sides of the throat. The adenoids are grouped together at the back of the throat behind the soft palate, spreading out toward the ear, nose and sinus openings. Every child has tonsils and adenoids, both of which ordinarily decrease in size after seven years of age. These structures can become enlarged and by their mere increase in size interfere with adequate drainage and function of those organs toward which they extend. The tonsils may become infected, form a true abscess, or be the source for secondary lymph gland infections in the neck and under the jaw. A considerable difference of opinion still remains about when and for what reason the tonsils and/or adenoids should be removed. All agree that the aim of the surgery is to reduce the frequency and severity of colds, ear infections, sinusitis and bronchitis.

What effect may adenoid infection have on the child? 

Acute infection and enlargement of the adenoid tissues may accompany frequent colds, a runny nose, cough, and bronchitis, and these respiratory infections tend to last longer when the adenoids are implicated. The infection often extends to the middle ear, causing painful inflamed ears and a temporary decrease in hearing acuity. Chronic adenoid infection can be associated with failure to gain weight in a normal fashion, since the child with chronic infections tends to become listless and to have a poor appetite.

Are the tonsils removed at the same time? 

If the child is under four years of age, the tonsils are ordinarily not involved in the way that the adenoids are. Since they are not diseased, they need not be removed. An additional consideration is that if the tonsils are removed, there tends to be an accelerated regrowth of the adenoids, sometimes necessitating a secondary or revisional operation on the adenoids.

When are the tonsils removed with the adenoids? 

Children over the age of four usually have a chronic adenoid infection accompanied by chronic tonsilitis. In that situation both the tonsils and the adenoids are removed in the same surgical procedure.

What are the symptoms of tonsil infection? 

The acute symptoms are those of a bad cold sore throat, enlarged glands in the neck, fever and temporary difficulty in swallowing.

When should surgery be performed? 

It should be done between infections one has to "steal" the child from between the colds, runny nose and ear infections. Antibiotics, the choice based on throat cultures, should be administered 48-72 hours before the operation. It has often been necessary to cancel and reschedule the operation because children have a way of getting reinfected at unpredictable times.

How can you tell that the tonsils and or adenoids are injected? 

The tonsils can be seen through the open mouth, the adenoids can be seen through the nose, and the middle ear can be inspected through a speculum.

What can happen if the adenoidal injection persists? 

The child will develop the facial expression of the mouth breather open mouth with pinched face. Snoring, a nasal quality to the voice and "sniffles" are further evidence of the extension of adenoidal tissue into the back of the nose. The ear infections can become chronic and result in a hearing loss.

How is the operation performed? 

The child is operated on either in the morning and goes home in the evening or in the afternoon and stays overnight. Most hospitals sensibly make provision for the mother to be there during the entire hospital stay. The operation is done under light general anesthesia on the child, who has not eaten or taken fluids for the preceding twelve hours. The child can be adequately sedated so that there will be no fear and no recollection of the procedure. A thorough checkup is required on admission to the hospital to be sure there is no infection.

What can the parents do to prepare the child jor this operation? 

This is a major part of the total experience. The child should know about going to the hospital and about the doctor and nurses. It has proven wise to read to the child one of several books on Going to the Hospital. This should be started almost two months in advance so that the child knows the text by heart and can identify each of the people in the illustrations. Such preparation eliminates fear of the unknown and avoids initiating a fear of doctors and hospitals that can last a lifetime.

Tonsils and Adenoids Surgery

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Are there any special postoperative instructions? 

The child should have liquids for the first day and a soft diet on the second and third. If there is any bleeding, the surgeon should be notified immediately and the child taken back to the hospital. The child may have an earache, but this soon goes away. Activities are restricted only for the first two or three days. Swimming is not advisable until the area has completely healed, which usually takes about fourteen days. Follow-up examinations should be done at two weeks and at six months.

How will I know if the operation has been successful? 

The operation can result in dramatic changes. The child becomes more energetic, eats better, and gains weight. Snoring is eliminated. In fact, the parent, grown accustomed to the child's sleep sounds, may even become needlessly apprehensive about the silent sleep for the first few days. More important, the frequency and severity of the colds, ear infections and bronchitis are considerably ameliorated. The results can be most gratifying.

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