Tonsils and Adenoids
What are they?
Tonsils and adenoids are collections of lymph tissue found in the throat and behind the nose. They are located near the entrance to the breathing passages where they come into contact with incoming viruses and bacteria. This can help the body in defense against these “germs” but the tonsils and adenoids may become infected themselves during the process.
Problems affecting Tonsils and Adenoids- The most common problems with tonsils and adenoids are recurrent infections and significant enlargement that causes obstruction and difficulties breathing, sleeping and swallowing.
When to see your ENT- When recurrent throat infections begin to affect activities of daily living such as recurrent antibiotic exposure and frequently missed school or work. When tonsils and adenoids are large with or without infections they may cause obstruction to breathing indicated by snoring and sleep disturbances. Patients with sleep apnea often have restless sleep and daytime sleepiness. Children tend to have behavioral problems if they are lacking in rested sleep
When to consider surgery?
Talk with your otolaryngologist about the indications for tonsillectomy and adenoidectomy. Information about how to prepare your child for surgery and care for them afterward is available through Superior Ear, Nose and Throat Specialists.
*Go to our Procedures page and view Tonsillectomy and Adenoidectomy
GERD and LPR
Definition- Gastroesophageal reflux or GERD occurs when acid from the stomach travels backward up into the esophagus. In some cases reflux can be silent, without any symptoms until problems arise. During GERD, acid may reflux up above the upper esophagus and into the back of the throat. This is known as laryngopharyngeal reflux or LPR.
Signs and Symptoms- Symptoms or GERD and LPR may include any and/or all of the following:
- Nighttime or persistent cough
- Trouble swallowing
- A foreign body sensation in the throat
- Frank chest discomfort and “heartburn.”
Diagnosis-Although these symptoms are straight forward for most patients it is desirable to have a complete throat examination to rule out any cancers or foreign bodies that may present with similar symptoms. The examination is done by an ENT practitioner in the office with topical anesthesia. A slim, soft and flexible scope is used, usually with a camera and often takes less than a minute to perform. The patient has no limitations afterwards and may return to work or school immediately afterwards.
Treatment- Children and adults usually respond favorably to a three to six month trial of medication. This may seem lengthy but the damage to the throat has usually been occurring for months, even years and may take that long to heal.
Lifestyle Modifications- Along with medication, certain changes in your eating and daily activities may further improvement and hasten healing. The following lists a few:
- Avoid eating/drinking within 2 hours prior to bedtime
- Avoid alcohol
- Limit caffeine, onions, garlic, peppermint, tomato and spicy foods
- Attempt weight loss
- Quit smoking
Snoring and Sleep Apnea
The snoring mechanism- When you breathe, air flows into your throat and past the uvula, tonsils, and tongue (tissues that make up the soft palate). While you are awake your muscles in your throat maintain a certain amount of tension to keep the throat open. At night these muscles relax, but there should still be a large enough opening for air to pass without problems. Sometimes however, those muscles relax too much or the structures in the throat are too large and while sleeping the passageway becomes obstructed. When this occurs the soft palate (tonsils and uvula) flap against ear other creating the loud noises known as snoring.
Sleep apnea- If the throat becomes completely obstructed while sleeping, air is unable to get through the throat and into the lungs. This is called sleep apnea and can cause significant problems with leading a healthy lifestyle and may progress to become life threatening if left untreated.
Signs and Symptoms of Sleep Apnea:
- Falling asleep at work or daytime sleepiness
- Morning headache
- Problems with memory and concentration
Diagnosis- Although a spouse or significant other may note or suspect the sleep apnea, a formal Sleep Study may be recommended to assess the type and severity of the apnea.
Treatment- Some patients have improved their sleep apnea with weight loss alone, others have not been so successful and go on to try a CPAP or continuous positive airway pressure device that is worn at bedtime. Surgical treatment may be discussed with your otolaryngologist and requires revision of the structures of the soft palate. This will depend on the severity of the sleep apnea and so a sleep study is usually ordered if surgery is being considered.
*Go to Procedures to read more about an injection Snoreplasty