Adult Tonsil Disorders
Ear Nose Throat Diseases
Tonsils are two tissues located on both sides of the throat entrance, between the base of the tongue and the uvula, which can change in size.
The adenoids, located behind the soft palate and uvula, in the upper back part of the throat where it joins with the nose, are also known as the nasopharynx region. Unlike tonsils, adenoids cannot be seen directly by looking into the mouth without specialized tools like angled endoscopy or a mirror.
Tonsils are enclosed in a capsule and are attached to the throat muscles, while adenoids do not have a capsule and are situated on top of the tissues in the nasopharynx. Tonsils and adenoids are immune system tissues that come into first contact with inhaled air and ingested food and liquids at the beginning of the respiratory and digestive systems.
What Are the Functions of Tonsils and Adenoids?
Causes of snoring according to their importance
- Excess weight is the most significant factor.
- The lower jaw being positioned backward or being small.
- The soft palate and uvula hanging down (elongation).
- Large tonsils, although less common in adults, can contribute.
- Deviated nasal septum, nasal polyps, or tumors, as well as nasal congestion.
- Excessive fat accumulation at the base of the tongue (which can be considered a part of obesity).
- Continuous use of sleeping pills or allergy medication.
- Sleeping on your back habitually.
- Alcohol and tobacco use (due to their potential to relax oral and soft tissues and cause nasal congestion).
Treatment of Snoring and Sleep Apnea
Tonsils and adenoids, along with the lingual tonsil and lymphoid tissue in the throat, constitute the portion of the throat known as the Waldeyer's ring, which plays a role in the body's defense system. They help the body's defense system by recognizing and transmitting information about microbes that enter through the mouth or nose, resulting in the production of cells and fluids by the lymphatic system to defend against those microbes.
Tonsil and adenoid tissue development begins before birth. Starting from 6 months after birth, they begin to grow due to genetic factors, infections, and allergic effects. Their functions are most important in the first 2-3 years of life and reach their maximum size at the age of 4-5. In subsequent years, the benefits of adenoids become negligible. Tonsils continue their function until the age of 8-10, after which they complete their mission and lose their activity. Adenoids completely disappear during adolescence.
Does Removing Tonsils and Adenoids Compromise Immunity?
Extensive scientific studies, along with laboratory tests and monitoring, have shown that children who have had their tonsils and adenoids removed from the age of 2-3 onwards do not exhibit any immune system deficiencies later in life.
However, like any tissue, as long as they do not pose a threat to an individual's health, there is no need to remove tonsils and adenoids.
Examination and Assessment of Tonsils and Adenoids
Medical history (information obtained from the patient's account)
Physical examination
Bacteriological culture
Radiological imaging
Blood tests
After obtaining detailed information about the patient's problems, a physical examination is performed.
During the examination of the nose and throat, specialized endoscopic cameras are commonly used in most centers instead of traditional light sources and small mirrors. Lymph nodes in the neck are also evaluated during the examination.
The decision to take a culture or perform blood tests is based on the condition and appearance of the throat. In rare cases where adenoids cannot be directly seen, a radiological examination may be beneficial.
What Are the Symptoms of Tonsil and Adenoid Infections, and What Complications Can Arise if Neglected?
Common symptoms of tonsil infections include fever, sore throat, difficulty swallowing, headache, weakness, and joint pain. The tonsils can be covered with gray-white infected material. Pharyngitis may also be added to the infection. Although acute tonsillitis usually heals easily, it can lead to complications (abscess formation near the tonsils, spread of infection to deep neck tissues, mixing of bacteria into the blood). Enlargement of tonsils and adenoids may occur after frequent throat infections. Depending on the size, it can cause airway obstruction, negatively affecting breathing. Impaired aeration of the middle ear due to chronic tonsillitis can lead to middle ear infections and partial hearing loss. Additionally, antibodies developed against streptococcus bacteria can cause diseases in other organs such as the heart, joints, and kidneys.
When Do Tonsils and Adenoids Cause Problems?
In children, the most common problems associated with tonsils and adenoids are recurrent infections and significant enlargement leading to breathing and swallowing difficulties.
Recurrent acute tonsillitis is more common in children but can also occur in adults.
If tonsil infections progress, an abscess can form around them.
Furthermore, due to chronic tonsillitis, small holes structurally present on the tonsils can widen, causing the accumulation of saliva and food residues, resulting in the formation of small pockets with a cheesy appearance and causing severe bad breath.
In rare cases, tumors can develop in the tonsils.
When Should You See a Doctor?
In the presence of the following conditions caused by tonsil and adenoid inflammation and enlargement, it is advisable to see a doctor:
Recurrent sore throats
Fever
Chills
Bad breath
Nasal congestion and postnasal drip
Recurrent ear infections
Mouth breathing
Snoring and sleep disorders
Treatment of Tonsil and Adenoid Infections
Any adult or child can experience tonsil infections once or twice a year. These are usually microbial tonsillitis cases that cause high fever and require antibiotic treatment. Bacterial tonsillitis, especially those caused by streptococcus bacteria (beta-hemolytic streptococci), are significant and can cause problems in the heart, kidneys, and joints. Early treatment with antibiotics, along with anti-inflammatory drugs and pain relievers, such as fever reducers, is essential.
In advanced diseases like infectious mononucleosis and Pfeiffer syndrome, corticosteroids may be necessary.In cases of recurrent, excessively enlarged tonsils and adenoids in children and adults where medications are not effective, tonsil and adenoid removal may be necessary.