Ear, Nose & Throat

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The tonsils are glands located on both sides of the back ofthe mouth. The tonsils are part of the immune system and help fight infections.

Tonsils can be subject by bacterial infection, and they can become swollen and inflamed, causing tonsillitis. This infection may affect nearby areas of the throat and raise other concerns

Tonsillitis is extermely common in children


Tonsillitis usually causes a severe sore throat and fever. Swallowing becomes painful and difficult.

Tonsillitis is considered to be chronic or dangerous if there has been

  • Five or more episodes in 1 year
  • Three or more episodes per year for 2 years
  • Episodes that do not respond to antibiotics

The tonsils may get large enough to touch eath other. When this happens, it's known as "kissing tonsils."

For children, tonsillectomy is advisable when tonsillitis attacks are so frequent or severe that they affect a child's general health or interfere with school, hearing, or breathing.


The health care provider will look in the mouth and throat for enlarged, visible tonsils. They are usually reddened and may have white spots on them. The lymph nodes of the jaw and neck may be enlarged and tender to the touch.

A culture of the tonsils may show bacterial infection. A culture for the streptococcus bacteria (strep) may be taken because it is the most common and most dangerous form of tonsillitis. A rapid strep test may also be performed by your physician by taking a throat swab for a quick diagnosis.


If the cause of the tonsillitis is bacteria such as strep, antibiotics are given to cure the infection. The antibiotics may be given once as a shot, or taken for 10 days by mouth.

If antibiotic pills are used, they must be taken for the full course. They must not be stopped just because the discomfort stops, or the infection will NOT be cured. Some health care providers will treat all tonsillitis with antibiotics to prevent the chance of strep-related complications. Others treat only known bacterial and strep infections.

Rest to allow the body to heal. Fluids, especially warm (not hot), bland fluids or very cold fluids may soothe the throat. Gargle with warm salt water or suck on lozenges (containing benzocaine or similar ingredients) to reduce pain.

Over-the-counter medications may be used to reduce pain and fever. Do NOT use aspirin in children if the infection could be viral, because this may be associated with Reye's syndrome.

Surgery to remove the tonsils (tonsillectomy) may be necessary for some people who have repeated infections.


Under general anesthesia, the ear-nose-throat (ENT) surgeon holds the mouth open using a mouth gag to expose the tonsils. The tonsils are then removed by being cut away with an instrument or a cautery (burning instrument). Bleeding is controlled, and the cut heals naturally without stitches.

Some physicians believe tonsillectomies are done more often than necessary, so a second opinion should be obtained when there is any doubt

Tonsillectomy is usually done on an outpatient basis, with the patient returning home the same day as the surgery. Only rarely are patients observed overnight in the hospital and return home the day after the surgery. Complete recovery can take 2 weeks. Expect some throat and ear pain in the first days following surgery. The use of ice packs to relieve pain may be used, although sucking on an ice cube or ice cream may provide adequate comfort. In addition, pain-relief medication may be prescribed. During recovery, it is recommended to eat soft, easy-to-swallow food and to drink a lot of cold fluids. The use of humidifier at home can also bring some comfort. Your child may experience alternating "good and bad" days for 2 weeks after surgery. It is a good idea to keep your child away from crowds or ill people for 7 days, since the throat is highly susceptible to infections during this period.

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