Tonsillectomy and adenoidectomy are common surgeries, especially in children. As a pediatric otolaryngologist at Phoenix Children’s ENT, I frequently discuss these procedures with concerned parents. Often, the conversation starts with understanding the basics: what tonsils and adenoids are, and importantly, Where Are Tonsils located in the body. Knowing their location is key to understanding their function and why their removal might be recommended.
One of the most frequent reasons for considering tonsil surgery is sleep-disordered breathing in children. Parents often describe symptoms like snoring, gasping for air during sleep, pauses in breathing, restlessness, excessive sweating at night, and persistent mouth breathing. These signs can be indicative of sleep apnea, which is also linked to bedwetting, night terrors, attention problems, hyperactivity, learning difficulties, and behavioral issues in children. In severe cases, sleep apnea can even lead to heart and lung complications.
Beyond sleep issues, other reasons for considering tonsil and/or adenoid surgery include recurrent throat or tonsil infections, chronic adenotonsillitis (persistent inflammation of the tonsils causing pain, tonsil stones, and bad breath), and recurring ear or sinus infections.
When discussing the necessity of surgery, parents understandably have questions. Among the most common are:
- What exactly are tonsils and adenoids?
- Where are tonsils and adenoids situated in the body, and what is their purpose?
- Are tonsils and adenoids essential for health?
Let’s address these questions to provide a clearer understanding of these often-discussed tissues.
Pinpointing Where Are Tonsils and Adenoids Situated
Where are tonsils located? Tonsils are positioned at the back of your throat, on both sides. You can often see them when you open your mouth wide in a mirror. They appear as pads of tissue on either side of the throat. The adenoid, while similar in tissue type, has a different location. It resides behind the nose, in the upper part of the throat, an area known as the nasopharynx. You can’t see the adenoids by simply opening your mouth.
Both tonsils and adenoids are strategically located as part of your body’s defense system. Their position at the entrance of the respiratory and digestive tracts allows them to intercept germs entering through the mouth and nose. However, this location can also become problematic. When tonsils and adenoids enlarge, they can obstruct airflow, particularly during sleep when muscles relax, leading to breathing difficulties through the nose and mouth.
Understanding What Tonsils and Adenoids Are Made Of
Tonsils and adenoids are integral components of the lymphatic system. They are composed of lymphoepithelial tissue, a type of tissue rich in cells that fight infection. While once considered vestigial organs with little purpose, we now understand that tonsils and adenoids act as filters, trapping bacteria and viruses that enter the body through the nose and throat.
Think of them as gatekeepers at the entrance of your body’s airways. However, these gatekeepers can sometimes become overwhelmed. Tonsils and adenoids can themselves become sites of chronic infection, acting as reservoirs for bacteria. When this happens, their ability to effectively filter and combat harmful “invaders” is compromised.
Assessing the Necessity of Tonsils and Adenoids
Fortunately, our bodies have a robust and multifaceted immune system. We possess numerous ways to combat infections and inflammation beyond just tonsils and adenoids. For individuals experiencing persistent and recurring inflammation or infections of the tonsils, research indicates that the immune cells within the tonsils become impaired. Once this functional decline occurs, the tonsils are no longer effectively providing local immune protection, nor are they adequately contributing to the overall immune system’s strength. In such cases, removing diseased tonsils can be beneficial.
It’s important to note the perspective of the American Academy of Otolaryngology – Head and Neck Surgery, which states that “There are no studies to date that demonstrate a significant clinical impact of tonsillectomy on the immune system.” For carefully selected patients, adenotonsillectomy proves highly effective in treating sleep apnea and chronic or recurring infections.
Details About Tonsil Removal Surgery
Adenotonsillectomy surgery is typically a relatively quick procedure, lasting around 45 minutes. The removal of both tonsils and adenoids is performed through the mouth, meaning there are no external incisions. Most patients are monitored post-surgery for a period before being discharged home on the same day. However, for younger children (under 3 years old), those with severe sleep apnea, obesity, or other complex health conditions, an overnight observation in the hospital is often recommended as a precautionary measure.
Recovery from a tonsillectomy and adenoidectomy generally takes about 7 to 10 days. Some individuals recover more quickly, feeling better within a few days, while others may require up to two weeks or even longer. Age-appropriate pain medication is prescribed to manage discomfort during the recovery period. While rare, potential risks include bleeding and dehydration, which infrequently necessitate further medical intervention.
If you are concerned about your child’s breathing, recurrent infections, or suspect they might benefit from a tonsillectomy and adenoidectomy, please reach out for a consultation. We are happy to discuss your concerns and evaluate your child to determine the best course of action.
