Infection and Enlargement of Tonsils and Adenoids

Tonsils and adenoids are lumps of tissue that are similar to the lymph nodes or “glands” found in the neck, groin, and armpits. Tonsils are the two “lumps” on the sides of the throat. Adenoids are high in the throat behind the nose and the roof of the mouth (soft palate) and are not visible through the mouth without special instruments.

Tonsils and adenoids play a part in defending the body against infection-causing germs by filtering these germs and developing antibodies to the germs. This happens during the first few years of life, becoming less important as the child gets older. In the process of filtering the germs, the tonsils and adenoids may become infected themselves. Children who must have their tonsils and adenoids removed suffer no loss in their disease resistance or immune system function.

The most common problems affecting the tonsils and adenoids are recurrent infections and significant enlargement or obstruction that causes breathing and swallowing problems.

Bacterial infections of the tonsils, especially those caused by streptococcus (strep throat), are first treated with antibiotics. Sometimes, removal of the tonsils and/or adenoids may be recommended. The two primary reasons for tonsil and/or adenoid removal are (1) recurrent infection despite antibiotic therapy and (2) difficulty breathing due to enlarged tonsils and/or tonsils. In addition, recent studies indicate an adenoidectomy may be beneficial treatment for some children with chronic earaches accompanied by fluid in the middle ear.

Nosebleeds

Nosebleeds are a condition commonly seen in children. Most cases resolve spontaneously and represent nothing more than a nuisance to the parent and child. Sometimes it becomes persistent and may require specific treatment. Rarely, it may be the presenting symptom of a serious local or generalized disease.

Nosebleeds are often the result of extremely dry nasal linings which lose the protective layer of mucus. This results in fragile tissue which has a tendency to bleed following the slightest trauma. Nosebleeds are most common during the winter months because of the increased incidence of colds leading to swollen nasal tissues with enlarged blood vessels. Central heating during the winter months dries the nasal linings.

When a nosebleed occurs, help the child to remain calm. Then: 1. Pinch all the soft parts of the nose together between your thumb and the side of your index finger or soak a cotton ball with Afrin, Neo-Synephrine, or Dura-Vent spray and place this into the nostril. 2. Press firmly but gently with your thumb and the side of your index finger toward the face, compressing the pinched parts of the nose against the bones of the face. 3. Hold that position for a full five minutes by the clock. 4. Keep the head higher than the level of the heart. Sit up or lie back a little with the head elevated. 5. Apply ice – crushed in a plastic bag or washcloth – to nose and cheeks.

More severe cases with frequent bleeding and significant blood loss may require more aggressive treatment. A chemical cauterization (burning) of the enlarged blood vessels using a silver nitrate stick can be performed in the doctor’s office. If bleeding recurs after an attempt at local cautery, more aggressive measures may be required including electrical cautery or surgery to tie off the bleeding blood vessel is possible. Surgical intervention is extremely rare in children.