Bacterial and viral infections of the tonsils (located on each side in the back of the throat)  and adenoids (located in the back of the nose) are very common in children. Antibiotics are very successful in treating tonsillitis, but for recurrent and chronic tonsillitis and adenoid problems, surgical removal of the tonsils and adenoids may be indicated.


Diseases of the tonsils and adenoids are among the most common problems in the pediatric population.

Tonsils are collections of lymphoid tissue located on each side of the back of the throat. Tonsils trap bacteria and viruses and help produce antibodies to fight infection.  This action diminishes rapidly with age.

Tonsillitis occurs when the tonsils become infected. This may be caused by bacteria or viruses.  Generally, under preschool age children develop viral tonsillitis, while older children and adults are affected by bacterial infections. Viruses can also lead to bacterial infections secondarily.  Common symptoms your child may experience with tonsillitis are:

  • Sore throat
  • Fever
  • Pain or difficulty in swallowing
  • Swollen neck glands
  • Ear pain

Antibiotics have been highly successful in treating tonsillitis and are the standard of care at this time.


Tonsillectomy is the surgical removal of the tonsils. A tonsillectomy is done when medical and supportive measures are not effective. This may be done both for recurrent infections or for chronically enlarged tonsils. Studies have shown that those with a history of bacterial infections which occur more than five to six times per year, or at least two to three times per day for several years, benefit from tonsillectomy. If your child has had persistent or recurrent sore throats, they should be checked by a physician to determine whether or not the episode was a case of tonsillitis.

Adenoids are collections of lymph tissue very similar to tonsils, found in back of the nose. As they are located near the entrance to the breathing passages, it is thought that their function is to sample or catch inhaled bacteria or viruses. In early childhood, this process is importance in the formation of the body’s immune system to fight infection. This function diminishes with age and is probably of minimal importance after 2 or 3 years of age.

What are the symptoms of enlarged or infected adenoids?

  • Difficulty breathing through the nose (mouth-breathing)
  • Snoring with sleep
  • Breathing pauses during sleep (sleep apnea)
  • Distorted speech (like the nose is pinched closed)

Adenoids are important because, when enlarged, they may obstruct air flow through the nose, forcing children to breathe through the mouth, or snore. In addition, the adenoid is located near the opening of the Eustachian tube, which drains the middle ear. Enlarged and infected adenoids may serve as a source of infection or bacteria to travel up the Eustachian tube into the middle ear. This results in an ear infection.
In cases where enlarged adenoids are chronically infected, significantly obstruct nasal breathing, or contribute to ear infections, removal of the adenoids has been found to be beneficial. This may be done in conjunction with a tonsillectomy for severe breathing difficulty during sleep (sleep apnea) or, along with ventilation tube placement in cases of chronic ear infections.

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