When Should I See An ENT Specialist?
If you or your child is experiencing recurrent throat infections, sometimes diagnosed with a throat culture, breathing problems, especially at night with snoring or gasping and certainly apnea episodes, difficulty swallowing or constantly talking like their nose is plugged you should be evaluated by an ENT Specialist.

What Are Tonsils and Adenoids?
Tonsils and Adenoids are masses of lymphoid tissue similar to the lymph nodes or "glands" in the neck and other areas of the body. The tonsils are the mass of tissue on either side of the back of the mouth. The adenoids are located above the roof of the mouth(soft palate) in the back of the nose. They are not visible through the mouth without a mirror. The tonsils and adenoids help to fight the germs or bacteria that cause infection and help prevent them from causing infections. By doing so they may sometimes become infected themselves.

The tonsils and adenoids may also help the body's immune system by filtering germs trying to invade the body and help develop antibodies to fight off the germs. They are important primarily and during childhood and become less functional as we get older. In fact they may shrink in size by our teenage years. We have not found, however, that children who have their tonsils and adenoids removed suffer any loss in their ability to fight infection.



Why Is My Throat Sore?
The most common problems affecting the tonsils and adenoids are recurrent infections and/or marked enlargement of the tonsils and adenoids causing obstruction, breathing, speaking and/or swallowing problems.

Chronic tonsillitis, abscesses behind the tonsils, and small pockets of infection can cause foul smelling breath, cheesy-like discharge from the tonsils or a white/yellow coating. This also leads to red, swollen, and sore throats. Tumors rarely occur and usually are present in the older population.

How Are Tonsil and Adenoid Disease Treated?
Initially a good history and physical exam is undertaken and if needed medication will be prescribed. Bacterial infections are treated with antibiotics.

Occasionally removal of the tonsils and/or adenoids may be recommended. The two main reasons for surgery are recurrent infections despite medical therapy and for obstruction of breathing due to enlarged tonsils and adenoids. Obstruction from enlarged tonsils and adenoids can lead to snoring, gasping and apnea that can lead to daytime sleepiness, behavioral problems in children and other medical problems. Abnormal facial growth patterns may develop in children who are chronic mouth breathers secondary to enlarged tonsils and adenoids

Are My Ear Infections Related To My Throat Infections?
Persistent or recurrent ear infections can be related to recurrent infections or enlarged tonsils and adenoids. The Eustachian tube , which connects the middle ear to the back of the nose, may not function properly due to tissue enlargement and/or act as a passage for bacteria to infect the ears.

Why Does My Child Keep Getting Ear Infections?
Over 90 % of children will have at least one ear infection by the time they are 3 years old. The 2 most consistent factors associated with otitis media are larger daycare centers and smoke exposure. The Eustachian tube functions to aerate the middle ear space. When this tube gets blocked pressure builds in the middle ear space and causes fluid to accumulate. This fluid acts as a culture medium for bacteria resulting in an infection. The are two ages that children tend to get ear infections: less than 1 year of age and school age(5-6 years old). There are a small percentage of children who will continue with ear problems through adolescence.

What Can Be Done?
Your physician will usually prescribe antibiotics for the infection. It is important to take the medicine as instructed. Although the earache may go away quickly, the infection may need more time to completely resolve. Your physician may also elect to place you on antihistamines and/or decongestants that may assist in treating an underlying cause of otitis media. Again it is important to continue your medicine as directed by your physician.

During an infection there may be some hearing loss associated with the fluid accumulation. Your physician can determine this by performing an audiogram(hearing test) or tympanometry. The fluid and hearing loss, if any, usually resolves in 3-4 months. If this fluid persists or if there are recurrent infections, an incision in the ear drum called myringotomy, and placement of a small tube can help correct the problem.

The pressure equalization(PE) tubes stay in the eardrum for 6 - 12 months. These tubes assume the function of the dysfunctional eustachian tube. The eustachian tube normally functions to maintain pressure balance and ventilation of the middle ear space. While the PE tube is in place, it is important to keep water out of the ear. We recommend silicone ear plugs available in the office.

Otitis media may also occur due to chronically infected or enlarged tonsils and adenoids. This may be a reason your doctor recommends removal of the adenoids and tonsils for recurrent otitis media.