What every mother needs to know about surgery to remove tonsils

Ear Nose and Throat specialist Mbira Gikonyo. (Photo: Beverlyne Musili, Standard) 

The hospital visits became numerous, tiresome and expensive. The sore throat, runny nose, bad breath, swollen tonsils and a horde of other throat-related complaints recurred every three weeks - whenever schools resumed for a new term.

The medications increased whenever Irene Kinga took five-year-old Andy, for a doctor’s appointment. But this term, the infections have reduced significantly after surgery to remove Andy's tonsils as well as the adenoids that were always infected.

The tonsils are your body’s first line of defence and together with the adenoids, they form part of the immune system to fight infections.

Where are the adenoids and tonsils located?

Ear Nose and Throat specialist Mbira Gikonyo explains that adenoids are located high in the throat behind the nose whereas the tonsils are the two collections of tissue on either side of the back of the throat.

Their function is to catch incoming infections and alert the body’s immune system to fight them.

“When bacteria and viruses enter the body, they get attached to the tonsils and adenoids, sometimes infecting them. The tonsils and adenoids alert the body to form antibodies to these germs to fight them,” said Dr Mbira in an interview with the Metropolitan.

First years

According to Mbira, who is also a head and neck surgeon, these body parts are most vital during the first few years of life, but they become less important as the immune system matures, as the child gets older.

Ongoing and recent medical studies have shown that removing them does not cause any loss of immunity. Mbira noted that viruses and bacteria cause the most common causes of tonsils infections.

“Children are in close contact with others at school and play, exposing them to a variety of viruses and bacteria, and making them vulnerable to the germs that cause tonsillitis,” said Mbira, explaining the frequent hospital visits when children are in school.

A parent, guardian or teacher can seek treatment for tonsils infection if the child complains of throat pain, difficulties swallowing, cough, fever and bad breath.

In some cases, swollen tonsils with a whitish or yellow coating can be seen at the back of the throat.

Enlarged neck glands and a hoarse voice are also common.

Once surgery is on the cards, both the doctor and parents or guardians of the child make a decision about removal of both the tonsils and the adenoids. Often, both are removed.

Acceptance of surgery is easier for children if they are assured that no organs will be removed and that the key goal is to reduce the instances of sore throats and other complications that keep them away from school and play.

“The same infections that give rise to enlarged tonsils often result in enlarged adenoids in the same patient. We ask parent for permission to remove both, but the final decision is made during the operation whether the adenoids can be spared if not enlarged,” Mbira explained.

Areas of concern

He warned that people with heart or lung disease may not be able to withstand the stress of an operation easily hence the need for more consultative advice.

Patients with cleft palate, bleeding disorders like haemophilia, leukaemia, purpura and anaemia should also consult doctors from other disciplines exhaustively before having this surgery.

The age of the patient should also be considered. If the patient is too young, below one year, or the elderly generally do not qualify for tonsillectomies as the potential risks outweight the benefits.

According to Mbira, there are no true adverse effects of not removing tonsils and adenoids; however, in some children the severity of complications or debilitating health conditions mainly related to the obstruction of the airway affects their well-being.

“Some children develop convulsions when a fever arises and chronically infected tonsils can worsen this, leading to epilepsy, whereas in others, asthmatic tendencies can develop into full-blown asthma,” he said.

Poor feeding due to frequently infected tonsils leads to malnourishment and this eventually affects both their final height and even intelligence, the doctor said, adding that outward-growing teeth are common in some children while others develop hearing loss as fluid accumulates in the ears.

They are also perennially tired due to poor sleep patterns; they cannot concentrate on their studies resulting in poor grades and low self-esteem.

Heart diseases

In extreme cases, Mbira noted that there were some patients whose enlarged adenoids and tonsils could cause both lung and heart disease, Cor Pulmonale, and at an advanced stage could lead to heart failure.

In all, he advised that frequent tonsils and adenoids infection should not be ignored.

“Get checked, especially children, so they can greatly value their childhood and be encouraged to thrive as they enjoy both school and play,” Mbira concluded.

“In very young children who cannot talk, refusal to eat and drooling may be the signs to watch for,” he added, noting that the treatment and management of tonsillitis was determined by whether the infection was caused by bacteria or viruses, and its aim was to stop the abrasive symptoms and infections.

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