Tonsils And Adenoids

The tonsils and adenoids are tissue that are part of the lymph system. Tonsils are the two masses located at the back of the throat. The adenoids are located on the roof of the mouth, behind the nose and soft palate. Researchers believe the tonsils and adenoids work as filters for the body's immune system, catching germs and other invaders as they enter through the respiratory system.

At birth, the tonsils and adenoids are very small. The tissue masses gradually increase in size until about 6 or 7, then start to shrink. Eventually, the function of fighting infections is largely taken over by other lymphatic tissues.

The most common problem associated with tonsils and adenoids is recurrent infection. Symptoms can include a red and swollen throat, pain when swallowing, headache, fever and ear pain. White patches of pus may be seen on the tonsils and a patient may have bad breath. Swelling and enlargement of the adenoids can block the nasal passages, leading to mouth breathing, noisy breathing, snoring and recurrent ear infections.

Tonsil Treatments

Tonsillitis can be treated with pain relievers, salt water rinses and, if necessary, antibiotics. If the throat infections are frequent or severe, doctors may recommend removal of the tonsils (tonsillectomy). Sometimes the adenoids are also removed (an adenoidectomy).

Tonsillectomy used to be a fairly common procedure. Now, doctors have developed better treatment for tonsillitis. The most common reason for a tonsillectomy today is obstruction of the airways. In 1994, there were 263,000 tonsillectomies in the U.S. and 142,000 adenoidectomies without tonsillectomy.

Tonsils and Sleep

Researchers at the University of Michigan Medical Center recently conducted a study on sleep and behavior for children needing a tonsillectomy/adenoidectomy. Prior to surgery, children underwent a sleep study and were evaluated by a child psychiatrist and neuropsychology team. Investigators also performed a test of daytime sleepiness. The tests were repeated one year after having surgery for removal of tonsils/adenoids. A group of peers was used as a control group.

Before surgery, the children who were scheduled for tonsillectomy/adenoidectomy were rated as much more hyperactive and inattentive than the children in the control group. One year later, the children who had the surgery showed significantly better behavior scores. In fact, at the end of the study, there was little difference in behaviors between the two groups of children.

The researchers also found that some of the children with sleep-disordered breathing who were not initially identified as having ADHD, met the criteria for the condition one year later. The reason for the sudden appearance of the condition isn't known. However, researchers speculate the damage associated with breathing problems during sleep may be permanent and, in some children, may not show up until later.

Sleep Specialist, Robert Chervil, M.D., says the study shows a link between enlarged tonsils/adenoids, sleep problems and behavior problems. Surgery is not a cure for behavior problems. However, if a parent notices that a child is snoring loudly (a symptom of obstructed breathing)) or isn't sleeping well and struggles with daytime behavior issues, further evaluation for sleep disorders or enlarged tonsils or adenoids may be warranted.

For general information on tonsils, adenoids and treatment: American Academy of Otolaryngology- Head and Neck Surgery