1. What is tonsillitis?
Tonsillitis refers to inflammation of the pharyngeal tonsils which are the glands that can be visible through the mouth at the back of the throat. The inflammation may also affect other areas at the back of the throat including the adenoids and lingual tonsils (tissue at the back of the tongue).
There are several types of tonsil infection: acute, recurrent, and chronic tonsillitis and peritonsillar abscess (quinsy):
Acute Tonsillitis: Sudden onset of tonsil infection, with no recent history.
Recurrent tonsillitis: This diagnosis is made when an individual has multiple episodes of acute tonsil infection in a year.
Chronic tonsillitis: Individuals often have chronic sore throat, halitosis, tonsil infection, and persistently tender cervical nodes.
Peritonsillar abscess – quinsy throat: Individuals often have severe throat pain, fever, drooling, foul breath, trismus – difficulty opening the mouth, and muffled voice quality, such as the “hot potato” voice (as if talking with a hot potato in his or her mouth).
2. What are the symptoms?
Tonsil infection can cause many symptoms, commonly sore throat, odynophagia (painful swallowing), fever, and foul breath. Other symptoms include; tender/enlarged lymph nodes in the neck; airway obstruction due to swollen tonsils provokes mouth breathing, snoring and sleeps apnea (nocturnal breathing pauses); sweats; rigors; and throat hoarseness. Lethargy and malaise are also common.
3. What is the cause of tonsillitis? Can it be avoided?
An infection of the tonsils causes tonsillitis. These can be viral or bacterial infections and immunologic factors. Bacteria cause 15-30 percent of pharyngotonsillitis cases.
Other causes include:
- Herpes simplex virus – Cold sore virus
- Streptococcus pyogenes -Strep throat
- Epstein-Barr virus – Glandular fever
- Cytomegalovirus – CMV
- Measles virus
Tonsil infection is hard to avoid, but simple hygiene routines such as hand hygiene can reduce the chance of spreading or contracting illness.
4. How common is it and is there a percentage of Australians that suffer from tonsillitis?
- Tonsillitis is fairly common with nearly all children experience at least one episode of tonsil infection.
- Tonsillitis usually occurs in children between 4 and 7 years of age.
- It is uncommon in those under 2 or over 40.
- The severity and duration varies, and some may not experience another episode again.
5. Is it more common in children?
Often symptoms are more severe in children due to narrow airways – the enlarged tonsils affect children’s breathing and swallowing.
6. How is tonsillitis generally treated?
Acute tonsillitis is generally treated with antibiotics, typically a penicillin, however if allergies exist alternatives may be prescribed.
If recurrent tonsil infection occurs (7 episodes in 12months), medical treatment does not work or there are other complications (sleep apnea) this is an indication that tonsillectomy may need to be performed.
Tonsillectomy is a surgical procedure often performed adjunct to adenoidectomy that is the surgical removal of the inflamed tissue.
7. What else can a patient do to help alleviate the pain?
A regular analgesic (pain relief) schedule is implemented, usually contained regular paracetamol and often something stronger such as tramadol for breakthrough pain. Another useful way of alleviating pain is sucking on ice blocks, or eating frozen/cold items which helps reduce swelling and ‘numb’ the area locally.
8. At what point are tonsils surgically removed?
Generally tonsillectomy is offered where:
- The infection is recurrent or chronic.
- Where there is a decreased quality of life.
- When medical treatment has been unsuccessful.
- When breathing and sleep are affected.
- When there are complications including febrile convulsions in children, quinsy throat infection, rheumatic fever, etc.
9. Is this a common problem these days?
It is still a common occurrence these days, as overcrowding in cities, and being exposed to virus and bacteria increases the spread of tonsil infection.
10. How often would you perform this procedure?
Our surgeon generally performs this surgery routinely on adults and children.
11. Is it painful? What is the recovery like for the patient?
Yes tonsillitis is painful and can cause pain on swallowing, with medical treatment these symptoms should improve. After a tonsillectomy, local pain is to be expected with a recovery period of 10-14 days. It is important to be proactive regarding pain relief.
12. For those that suffer regularly from tonsillitis, is it something they might eventually grow out of? Is there an age that it might stop happening?
For those who suffer from recurrent/chronic tonsillitis it is not something that you will ‘grow out of’. Although more common in children, tonsillitis can also affect adults. It is better to get tonsillitis treated effectively especially if re-occurrence happens.
If you have questions about tonsillitis contact your local doctor, who will arrange for you see an ear nose throat surgeon.