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Enlarged tonsils

Condition Overview:

Tonsils and adenoids are collections of lymphoid tissue that help the body fight infection. Thetonsils are located on both sides of the back of the throat. The adenoids are located higher and further back, where the nasal passages connect with the throat, and are not visible through the mouth. However, tonsils and adenoids can becomeenlarged—for example, when they become infected with bacteria that cause pharyngitis. When this happens, thetonsils become more prominent and the adenoids may block the nose. Usually, the tonsils and adenoids return to normal size once the infection is over. Sometimes they remainenlarged, particularly in children who have had frequent or chronic infections. Although extremely rare, cancer sometimes causesenlarged tonsils or adenoids in children.

Most enlarged tonsils and adenoids cause no symptoms; some degree of tonsillar enlargement is even considered normal in preschool and adolescent children. However, children with enlarged tonsils or adenoids can experience sore throat and discomfort or pain with swallowing. Enlarged adenoids can give the voice a "pinched nose" quality and lead to changes in the shape of the child's palate and the position of the teeth.
Enlarged tonsils and adenoids are considered a problem when they cause more serious effects. They can cause chronic ear infections and hearing loss due to obstruction of the eustachian tube and fluid accumulation in the middle ear. They can also cause recurring sinus infections and nosebleeds. Some children have obstructive sleep apnea (see Sleep Disorders: Sleep Apnea Syndromes), with snoring and brief periods without breathing; this can cause low oxygen levels in the blood, frequent waking, and daytime sleepiness. Rarely, obstructive sleep apnea caused by enlarged tonsils and adenoids can lead to serious complications, such as high blood pressure in the lungs (pulmonary hypertension) and changes in the heart that result from pulmonary hypertension (cor pulmonale (see Cor Pulmonale: A Disorder Stemming From Pulmonary Hypertension).

Children with enlarged tonsils can also lose or fail to gain weight, either because of pain and difficulty eating or because of the constant physical effort it takes for them to breathe.