Tonsils and the Adenoids

In years past, it was very common for children to have their tonsils and the adenoid taken out. Today, doctors know much more about tonsils and the adenoid and are more careful about recommending removal.

The tonsils are oval-shaped, pink masses of tissue on both sides of the throat. Tonsils can be different sizes for different children. They can be large or small. There is no "normal" size. You can usually see the tonsils by looking at the back of the mouth with a flashlight. Pressing on the tongue may help, but this makes many children gag. Instead, ask your child to open her mouth wide and say, "aaahhh." This will usually cause the tongue to flatten just enough to see the back of the throat more clearly. The uvula, a fleshy lobe that hangs down in the back of the mouth, should not be mistaken for the tonsils.

The most common illness associated with the tonsils is tonsillitis. This is an inflammation of the tonsils usually due to infection. There are several signs of tonsillitis, including:

Red and swollen tonsils
White or yellow coating over the tonsils
A "throaty" voice
Sore throat
Uncomfortable or painful swallowing
Swollen lymph nodes ("glands") in the neck
Fever

The adenoid is often referred to as "adenoids." This is incorrect because the adenoid is actually a single mass of tissue. The adenoid is similar to the tonsils and is located in the very upper part of the throat, above the uvula and behind the nose. This area is called the nasopharynx. The adenoid can be seen only with special mirrors or instruments passed through the nose.

It is not always easy to tell when your child's adenoid is enlarged. Some children are born with a larger adenoid. Others may have temporary enlargement of their adenoid due to colds or other infections. This is especially common among young children. Constant swelling or enlargement can cause other health problems such as ear and sinus infections. Some signs of adenoid enlargement are:

Breathing through the mouth instead of the nose most of the time
Nose sounds "blocked" when the child talks
Noisy breathing during the day.
Snoring at night

Both the tonsils and the adenoid may be enlarged if your child has the above symptoms along with any of the following:

Breathing stops for a short period of time at night during snoring or loud breathing ( this is called "sleep apnea").
Choking or gasping during sleep.
Difficulty swallowing, especially solid foods.
A constant "throaty voice," even when there is no tonsillitis.

Both the tonsils and the adenoid are part of your body's defense against infections. Since similar tissues in other parts of the body do the same job, removal of the tonsils or the adenoid does not harm the body's ability to fight infection.

Updated January 2002