Children’s ENT: When are their adenoids and tonsils a problem?

  • August 22, 2020

What’s the difference between adenoids and tonsils?

Many of my patients confuse adenoids and tonsils as the same part of the human anatomy. These are important parts of the body’s immune system as they are located at areas which are more vulnerable to the transmission of disease and infection. 

The tonsils are found at the back of the throat and are visible as curved, lumpy pieces of flesh. 

Adenoids can’t be seen from the front of the oral cavity without the use of medical tools. They are glands that are found between the area behind the nose and the soft palate. These parts of the anatomy play a similar role as the lymph nodes in our body, cleansing the body of bacteria and helping to fight infection. 

Find out more about adenoids and tonsils here https://www.msdmanuals.com/home/children-s-health-issues/ear-nose-and-throat-disorders-in-children/enlarged-tonsils-and-adenoids-in-children.

Inflamed Tonsils
Adenoid Nasopharyngeal Tonsil

In children especially, these parts of the throat tend to be more susceptible to infection as children have weaker immune systems. These infections often occur when a child has a condition like a cold, fever or flu.

What is tonsillitis in children?

When the tonsils of a child gets inflamed due to a bacterial infection, it is known as tonsillitis. This can be either caused by bacteria or a virus. Bacterial tonsillitis is sometimes known as strep throat, as the bacteria that causes this is called Streptococcus pyogenes. This is a common condition and parents should not be too alarmed if their child has tonsillitis.

However, in older children or younger teens, a severe infection of the throat called glandular fever can cause tonsillitis that can become more serious and potentially dangerous.

The symptoms of tonsillitis include:

  • Soreness at the back of the throat
  • Dry throat
  • Hard to swallow saliva
  • Pain when opening one’s jaw or chewing
  • A high fever
  • Halitosis (bad breath)
  • Aching joints

If your child has issues with their adenoid or tonsil, consider visiting ENT Surgeons.

When should I bring my child to the doctor? Is home care sufficient?

For mild cases of tonsillitis, you do not need to bring your child to the doctor and generally just rest with lots of water consumption at home is adequate. Directions for home care include:

  • Plenty of bed rest
  • Avoid strenuous activities
  • Take painkillers like Panadol or NSAIDs
  • Drink plenty of fluids to ensure hydration
  • Avoid spicy foods

If your child is having a high fever or is in severe pain, then bring your child to the nearest GP or A&E immediately. In the case of severe inflammation, your child might suffer from respiratory difficulties due to reduced airflow. 

Do I need antibiotics for a tonsillitis infection?

If the tonsillitis is viral in nature, then you do not need a course of antibiotics to cure it. 

If your child is prescribed antibiotics for their tonsillitis, do ensure that they finish the entire course of treatment.

Adenoids and your child

What are enlarged adenoids in children?

Adenoids are a particularly important part of the anatomy in children as they work to fight infection when a child is very young. Their importance that they play in germ fighting reduces gradually as the child ages and develops other mechanisms for fighting infections. Adenoids will start to reduce in size after age 5 and are often completely diminished by the time the child hits their teens.

Adenoids are similar to tonsils in that they have the function of trapping germs from entering the body, swelling up when they are attempting to fend off a potential infection. This swelling is usually temporary and goes down by itself. However, adenoids can become enlarged and infected themselves, causing pain and discomfort. 

If this becomes a chronic condition, surgery might be needed to remove the adenoids completely in a procedure known as an adenoidectomy. 

What issues can having enlarged adenoids cause in children?

If your child has swollen adenoids, this can affect airflow and cause a variety of other problems, including:

  • Blocked airways
  • Forced breathing through the mouth (dry mouth and airway)
  • Swollen or painful glands around the neck
  • Pain in the ear

If your child is suffering from any of these symptoms, bring them to a doctor to get their throat checked out.

The doctor might suggest an x-ray or use a special tool to look into your child’s nose. If your child’s adenoids are compromised, the doctor might prescribe your child with a course of antibiotics. Be sure that your child finishes this entire course of medication.

When is an adenoidectomy required?

If the adenoids remain chronically inflamed and do not respond well to conventional medication, then your child might need to go for an adenoidectomy to get them removed. This is an invasive in-patient surgery. This is sometimes combined with a tonsillectomy if the child is suffering from tonsillitis. While these surgeries may sound scary, these are actually rather common surgeries that kids can opt for.

Both these surgeries are done under general anaesthesia, so no pain or discomfort will be felt as your child peacefully sleeps during the surgery. 

After surgery, your child may need to avoid solid food for awhile. It usually takes between 1-2 weeks to fully heal after the surgery.