[blparent] Tonsils, in or out?

[Veronica Smith]

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Children's Health
 >  Your Child's Tonsils: In or Out?
Your Child's Tonsils: In or Out?
When many of us were growing up, the cure-all for throat infections and
breathing
problems was removal of the tonsils and adenoid. Today, these operations are
rarely
recommended. Find out when your child's tonsils or adenoids should be taken
out and
-- perhaps more importantly -- when they shouldn't.
Remember how terrified you were as a child when you had to go to the
hospital to
have your tonsils removed? The operation to end recurrent sore throats was a
childhood
rite of passage, and after surgery we were rewarded with heaping plates of
ice-cream.
Kids who breathed through their mouths had their own war stories about
having their
adenoid taken out. Today, most children are spared such operations because
doctors
know more about these tissues and how to deal with infections.
What Are Tonsils and the Adenoid?
The tonsils are a pair of small almond-shaped masses on either side of the
throat.
These structures act as a defense against infections that invade the body
through
the nose and mouth. Tonsils are part of the body's protective lymphatic
system, which
dispatches cells that literally devour bacteria. The Adenoid is a grape-like
mass
of tissue located above the tonsils, behind the nose. Its role is to help
fend off
respiratory-tract infections.
What Are Symptoms of Tonsillitis and Enlarged Adenoid?
Occasionally, the tonsils become overwhelmed by a bacterial infection. This
infection,
known as tonsillitis, usually strikes children between the ages of three and
six.
The symptoms of tonsillitis are similar to those of the flu, so it may be
tricky
to distinguish between the two. Signs of infection include difficulty
swallowing;
red and swollen tonsils; white or yellow spots on the tonsils; sore throat;
swollen
glands in the neck, and fever.
The adenoid may swell temporarily when a child has a cold or other
infection, but
constant swelling can cause ear and sinus infections. Signs of an enlarged
adenoid
include breathing through the mouth instead of the nose; a nasal quality to
the voice;
noisy breathing; and snoring. If in addition to having above symptoms, your
child
stops breathing for short periods during the night and always seems to have
a "throaty"
voice, both the adenoid and tonsils may be swollen.
How Is Tonsillitis Treated?
Sometimes tonsil and adenoid tissue swell and then return to normal without
treatment.
But if your child has symptoms more than 48 hours or has a history of
tonsillitis,
see your pediatrician. An untreated infection can lead to a painful abscess
in or
around the tonsils. The doctor will examine your child's throat and take a
throat
culture. If tonsillitis is diagnosed, a 10-day supply of an antibiotic will
probably
be prescribed. Symptoms should disappear within a few days, but it is
important to
finish all of the medication to keep the infection from making a come back.
When Is Surgery Called For?
Tonsils or the adenoid may have to be removed (usually when a child is six
or seven)
under certain conditions. These include:
Swelling makes breathing or swallowing difficult.
An enlarged adenoid distorts speech.
A swollen adenoid causes repeated ear or sinus infections.
An excessive number of sore throats or stubborn tonsillitis that doesn't
clear up.
Lymph nodes beneath the jaw remain swollen even with antibiotic treatment.
What Exactly Does the Surgery Involve?
Tonsillectomy and Adenoidectomy are surgical procedures that require general
anesthesia.
Help make surgery less frightening for children by explaining what will
happen, answering
their questions and assuring them that you'll be nearby throughout the
operation.
During surgery, the tonsil or adenoid tissue is removed and the cut area is
left
to heal naturally. These are simple operations but like all surgery, a small
amount
of risk is involved. The procedure can be done either in a hospital, which
requires
a stay of a day or two, or it can be done on an outpatient basis so that the
child
can recuperate at home.
Your child's throat will be sore for several days after the operation. Soft
foods,
including ice cream, custards, and soups, can help soothe the pain. Children
can
look forward to returning to their normal activities within a week after the
operation.
Common Myths About Tonsils and the Adenoid
Don't be tempted to have your child's tonsils or the adenoid removed because
of any
of these common tall tales:
"Tonsils are useless."
Not true. Researchers continue to report new evidence that shows tonsils are
a valuable
part of the body's defense mechanism against invading germs and viruses.
"Tonsils are making my child sick."
Chances are your child is going through a normal stage of growth,
irrespective of
the condition of the tonsils. Before children can build up antibodies to
fight off
`bugs,' they must be exposed to them. So a certain number of mild
respiratory diseases
are expected during a child's early years.
"Children are healthier without them."
It's not true that a tonsillectomy or adenoidectomy makes a child less
susceptible
to colds, sore throats and other respiratory ailments. Nor do the operations
relieve
an allergy or a chronic problem such as asthma.
"They're swollen."
There is no standard size for tonsils; they can be large or small. What you
perceive
as swelling may be the tonsils' normal size. Tonsils are very small at
birth, enlarge
gradually, and reach maximum size at age six or seven. After that, they
usually shrink
to walnut size. An adenoid grows between the ages of three and five and then
shrinks,
eventually disappearing altogether during puberty. Unless a medical problem
is diagnosed,
enlargement alone is no basis for surgery.