The reasons for recommending tonsillectomy are not many, and parents should have an idea as to what they are:
- Respiratory obstruction: This is the major reason why tonsils must be removed. Even large ones (which can become dangerously enlarged if suddenly infected) in some cases can close over the back of the throat and make breathing difficult. There is no doubt about the necessity of having these removed.
- Recurring tonsillitis requiring antibiotics: If the child has three attacks of acute tonsillitis a year for two years, the tonsils should be surgically removed. “This is the most common indication for the operation.” Dr. Edward Beckenham, ear, nose, and throat surgeon from the Royal Alexandra Hospital in Sydney states.
- Recurrent tonsillitis in a child who is allergic to antibiotics: This means that the usual medical treatment is not available to the patient. So, if antibiotics are still needed, and the patient is likely to develop reactions to them, then the operation must be considered.
- Recurring tonsillitis with convulsions. Many children become rapidly feverish during an acute attack of tonsillitis. Convulsions may occur. This is probably more common in younger children. However, if this tendency continues, then consideration should be given to the removal of the tonsils. Some doctors prefer to place the child on long-term penicillin therapy as an alternative. Many youngsters tend to grow out of the tendency to fit during fevers.
- Speech disorders: These are occasionally associated with large infected tonsils, making articulation difficult. If the child has been checked by a speech therapist, and it is considered necessary to have them removed for this purpose, then surgery is often beneficial.
- Persisting sore throats: Some children, despite every form of treatment, still have a series of sore throats that seem immune to routine treatment. It has been found that many of these children also benefit from surgery.
Most surgeons prefer not to operate on children under the age of four years. After the age of eight or nine, the need for surgery often lessens.
Often the adenoids are removed at the same time as the tonsils, but not necessarily. Sometimes, the adenoids may be removed while the tonsils appear to be healthy.
Recurring middle ear infections and nasal obstruction are the two most common reasons why the adenoids are removed. Adenoids are tissue that grows near the tonsils, behind the nasal passages as they meet at the back of the oral cavity. Nasal blockage can cause mouth breathing and restless nights, although allergies also often produce this symptom.
A bout of acute tonsillitis usually results in a sore throat. The glands under the jaw often swell and become tender to touch. There is often a high fever which may come on suddenly. Aches, pains, and shivers, and a tingly skin are common symptoms.
The tonsils, seen at the back of the oral cavity as two pinkish enlargements, become red. Often splotches of pus are scattered over their surface, or a sheet of yellow-whitish pus may almost entirely cover them.
Treatment today is by antibiotics. The penicillin or the semi-synthetic penicillins, or other wide-spectrum antibiotics usually bring a rapid cure. An initial injection may be given by the doctor, and this followed up by oral capsules or syrups. Often medication to reduce temperatures and relieve pain are given also.
Fluids and later soft foods are recommended. Bed for a few days in the acute stages is worthwhile, for the patient usually feels off-color or downright ill. It is usually more uncomfortable in adults and the disorder may persist for longer periods. But fortunately, nearly everyone can be cured relatively rapidly today.