Tonsil and Adenoid Infections:
Realities & Myths
Most of the children get frequent ear, nose, and throat infections from the time they start going to play school till the age of 6-7 years.
This leads to lot of anxiety in the parents, thinking their “ward” is particularly “weak”. But we should try to understand that this is a normal process by which the immune system of the body acquires the basic information about the “germs” of the child’s environment.
With each sub-clinical and clinical infection by virus and bacteria, the immune system develops antibodies to fight out that specific germs.
But as the body is unprepared during the first attack, it may become ill sometimes.
Each attack of infection also prepares the immune system to retain that information and produce antibodies in greater quantity during second attack. So most of the second attack by same virus and bacteria are aborted earlier.
But, as there are thousands of varieties of virus and bacteria capable of producing infections, most of the children are bound to get few ENT infections in a year-till the body’s immune system gets information about mot of the germs (which happens around 6-7 years of age).
As nose and throat are the main portals of entry for air, food and water into our body-a major component of immune system called “Waldeyer’s ring” is situated at these sites.
Waldeyer’s ring is actually a “ring” of lymphoid tissue at the back of mouth and behind the nose. “Tonsils” and adenoids are lymphoid tissues, which form a part of Waldeyer’s ring.
Yes, every person has tonsils-which are collection of lymphoid tissue on either side of throat a little behind the tongue. Likewise, adenoids are lymphoid tissue situated at the back of the nose.
Most of the tonsil infections are part of generalized cough and cold. But if the child complaints of throat pain, associated with some difficulty in swallowing and fever, Nasal decongestant it suggests a greater degree of tonsil infection.
In medical term it is called “Acute Tonsillitis”. If a child or person develops more than more than 3 attacks of sore throat with fever, the condition may be called as “Chronic Tonsillitis” but a better term is “recurrent Tonsillitis”.
Sometimes, with some virulent bacterial germs, infection can spread beyond the covering of the tonsil and results in “peritonsillar abscess” which needs urgent treatment and it can be life threatening.
Sometimes particular strain of streptococcal bacterial infection of tonsil can lead to inflammation of heart and joint called as “rheumatic fever”.
Rheumatic fever is still a major cause of heart disease in our country with life long sequelae.
In some individuals, tonsil can act as a reservoir of infection leading to frequent sore throats.
If that individual suffers from severe sore throat with fever 5-6times a year that result in missing school/work, then doctors should advise him/her to undergo tonsillectomy.
Also, sometimes, the size of tonsils becomes so big that it causes problems during swallowing or obstruction to airflow then also it needs to be removed.
Some times if a tumor is suspected in the tonsil area it is removed for biopsy.
These are the usual indications for tonsil removal.
Does Tonsil removal result in reduction of body resistance?
Not at all. As there are 6 pairs of lymphoid tissue aggregation in Waldeyer’s ring, removal of one pair (tonsils) does not matter much.
Its functions are taken over by other lymphoid tissue.
Tonsil removal is not a minor operation. Main problem during and after the operation is bleeding especially in small children. A little more than usual blood loss can be dangerous. Other problem is pain in the post operation period. Both of these problems has been overcome to a large extent recently by “COBLATION” Technique.