Tonsils are the two round lumps in the back of your throat. Adenoids are high in the throat behind the nose and the roof of the mouth (referred to as your soft palate). They are not visible through the mouth or nose without special instruments.
Tonsils and adenoids are part of the immune system and help protect the body from disease. They “sample” bacteria and viruses that enter through the mouth or nose. Unfortunately, sometimes they can get infected or cause problems by being too large.
Tonsillitis is an infection of the tonsils. Symptoms may include:
If your or your child’s tonsils or adenoids are enlarged, it may be hard to breathe through the nose, or cause difficulty while sleeping. Other signs of adenoid and/or tonsil enlargement include:
You should see your ENT (ear, nose, and throat) specialist, or otolaryngologist, when you or your child experience the common symptoms of infected or enlarged tonsils or adenoids.
The two most common problems of the tonsils and adenoids are caused by infection. Tonsil swelling can block the airway, or a person can experience repeated bacterial infections. These infections can contribute to breathing problems, nasal obstruction and swallowing difficulties, and sleep problems.
Abscesses around the tonsils, chronic tonsillitis, and infections of small pockets within the tonsils that produce foul-smelling white deposits can also affect the tonsils and adenoids, making them sore and swollen. Cancers of the tonsil, while uncommon, require early diagnosis and aggressive treatment.
Your physician will ask about problems of the ear, nose, and throat, and examine the head and neck. They may use a small mirror or a flexible lighted instrument to see these areas. Other methods used to check tonsils and adenoids are:
Bacterial infections of the tonsils, especially those caused by streptococcus, are first treated with antibiotics. Tonsillectomy, removal of the tonsils and/or adenoids (adenoidectomy), can be an option when infections return frequently even after antibiotic therapy or there is difficulty breathing with the enlarged tonsils and/or adenoids.
Frequent infections of the adenoids can affect other areas such as the ear’s passage between the back of the nose and the inside of the ear, known as the eustachian tube. This can lead to frequent ear infections and collection of fluid in the middle ear that may cause temporary hearing loss. Removal of the adenoids may help some children with chronic earaches accompanied by fluid in the middle ear (called otitis media with effusion).
In adults, the possibility of cancer or a tumor may be another reason for removing the tonsils and adenoids. In some patients, especially those with infectious mononucleosis, severe enlargement may obstruct the airway. For those patients, treatment with steroids (e.g., prednisone) is sometimes helpful.
Copyright 2021. American Academy of Otolaryngology–Head and Neck Surgery Foundation. Last reviewed April 2020.