At Pediatric ENT of Oklahoma, we see a lot of children with swollen tonsils. A National Health Statistics Report estimates over 700,000 tonsillectomy procedures are performed every year. While it is not always necessary, tonsil removal can improve quality of life and provide effective treatment for children with severe tonsil conditions.

What Are Tonsils?

Tonsils are lumps of tissue that sit in the back of the throat. People are born with four sets, but the palatine tonsils are the set we think of when we say “tonsils.” Another set, the adenoids, can also contribute to tonsil concerns. Palatine tonsils are visible when someone opens wide and says “aah,” but adenoids are tucked up behind the soft palette. It takes special instruments to see them, and they shrink until they virtually disappear by the time we reach adulthood.

All tonsils are a first line of defense in the body’s immune response. Small dips or folds in their surface allow them to filter inhaled air, analyzing it for pathogens like viruses and bacteria. If a pathogen is detected, tonsils stimulate the immune system and begin the immune response.

Why Do Good Tonsils Go Bad?

Enlarged tonsils can have a number of causes. Some enlargement is normal, but it becomes problematic if it interferes with breathing or contributes to chronic infection. Some of the more common reasons for chronic enlargement include:

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  • Infection
  • Allergies
  • Acid reflux
  • Other throat irritation

In the case of infection and allergies, the enlargement is due to the body’s immune system response. This is called tonsillitis. The body senses an invader, and the tonsils swell with antibodies and other immune cells to fight them off. In the case of chronic infection, the swelling may never subside or constantly recur.

Some children are born with naturally large tonsils. This can become an issue if the tonsils are large enough to contribute to airway obstruction, leading to conditions like sleep apnea. Any substance that can cause throat irritation can potentially contribute to tonsil enlargement as well. Gastric acids from acid reflux is one possibility, but inhaled irritants like smoke can also cause inflammation.

While tonsil trouble is usually associated with enlargement, it is possible for your child to have tonsillitis without it. Instead, the tonsils become tattered by repeated infections and may not enlarge significantly. The battered tonsils still become safe havens for bacteria and viruses, causes chronic infection without notable swelling.

More Than Just a Sore Throat

Enlarged tonsils can have a significant impact on your child’s daily life. For many children, tonsillitis or otherwise enlarged tonsils can cause:

  • Frequent sore throats, fevers and other chronic cold symptoms
  • Ear pain
  • Breathing difficulties
  • Trouble swallowing, especially dense foods like meats
  • Obstructive sleep apnea, leading to daytime drowsiness and behaviorial concerns
  • Frequent missed school days or poorer school performance
  • Poor quality of life from living with pain, discomfort and physical difficulties

Is a Tonsillectomy Necessary?

30 years ago, almost 90% of tonsillectomy procedures were performed due to chronic infection. Today, it is a mere 20%. 80% of procedures are performed for obstructive sleep apnea. Advancements in management protocols and more strict standards have drastically reduced the number of surgeries done overall. A specialist at Pediatric ENT of Oklahoma will evaluate your child’s overall health, throat and quality of life to determine the best course of action.

Non-surgical management is the preferred course of action in most cases. Even if your family care physician has run strep tests and prescribed antibiotics before, having a specialized approach may lead to pinpointing what is causing the inflammation.

We may evaluate your child’s health and home life for factors that could contribute to symptoms, such as testing for allergies. This can allow for a targeted and more effective treatment protocol. Surgery is reserved for severe, unrelenting cases that do not respond to other treatment options.

Surgery is more likely to be recommended if your child has:

  • Suffered more than seven episodes of tonsillitis in the past year
  • Difficulty breathing
  • Difficulty swallowing
  • Obstructive sleep apnea
  • Recurrent or treatment-resistant abscesses of the tonsils

Set Up Your Consultation

If you think your child is suffering from chronically enlarged tonsils, sleep apnea, difficulty swallowing or chronic throat infections, schedule a consultation with Pediatric ENT of Oklahoma today. To help us evaluate your child’s health accurately, consider how often he or she has struggled with symptoms past. Checking with the school attendance office or obtaining records from your family doctor may also help. Knowing what has already been done may save time and help put us on the right path.