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Conditions that impair ear function can be as minor as wax buildup or as serious as congenital deafness. This section contains valuable information about how to protect your hearing, how to recognize indications of hearing disorders, and what ENT-head and neck physicians can do to evaluate and treat these problems. Learn More »
Maladies of the throat can be a mere nuisance or a major ordeal. Tonsillitis, voice disorders, and even hoarseness all interfere with our ability to communicate. Many of these conditions can be improved or corrected with the care of an ENT physician or head and neck surgeon. Learn More »
Congestion, allergic rhinitis, a deviated septum, and mouth sores are just a few of the varied health problems that occur in this region of the body. Information about ways you can relieve symptoms at home and when you should see a physician can be found in this section. Learn More »
Many surgical advances are being made in this area. Procedures such as tonsillectomy and facial plastic surgery are becoming less invasive, and new procedures are being developed to treat serious problems such as cleft palate, sleep apnea, and deafness. Learn More »
Early detection is critical to preventing fatal outcomes. Cancers of the head and neck such as laryngeal cancer can be particularly aggressive. Signs of cancer of the head and neck include changes in the skin, pain, prolonged hoarseness, and sudden loss of voice. If you suffer from any of these symptoms you should see an ENT or head and neck physician immediately. Learn More »
Children face many of the same health problems that adults do, however symptoms may show themselves differently and treatment methods that work well in adults may not be appropriate for children. This section identifies common pediatric ENT, head, and neck ailments and what you should ask your child’s doctor about diagnosis and treatment. Learn More »
As always, you can contact our office to answer any questions or concerns.
Tonsillitis refers to inflammation of the pharyngeal tonsils (glands at the back of the throat, visible through the mouth). The inflammation may involve other areas of the back of the throat, including the adenoids and the lingual tonsils (tonsil tissue at the back of the tongue). There are several variations of tonsillitis: acute, recurrent, and chronic tonsillitis, and peritonsillar abscess.
Viral or bacterial infections and immunologic factors lead to tonsillitis and its complications. Nearly all children in the United States experience at least one episode of tonsillitis. Due to improvements in medical and surgical treatments, complications associated with tonsillitis, including mortality, are rare.
Who gets tonsillitis?
Tonsillitis most often occurs in children, but rarely in those younger than two years old. Tonsillitis caused by bacteria (streptococcus species) Streptococcus species typically occurs in children aged 5 to 15 years, while viral tonsillitis is more common in younger children. A peritonsillar abscess is usually found in young adults but can occur occasionally in children. The patient's history often helps identify the type of tonsillitis present (i.e., acute, recurrent, chronic).
What causes tonsillitis?
The herpes simplex virus, Streptococcus pyogenes (GABHS), Epstein-Barr virus (EBV), cytomegalovirus, adenovirus, and the measles virus cause most cases of acute pharyngitis and acute tonsillitis. Bacteria cause 15-30 percent of pharyngotonsillitis cases; GABHS is the cause for most bacterial tonsillitis. (i.e., “strep throat”).
What are the symptoms of tonsillitis?
The type of tonsillitis determines what symptoms will occur.
- Acute tonsillitis: Patients have a fever, sore throat, foul breath, dysphagia (difficulty swallowing), odynophagia (painful swallowing), and tender cervical lymph nodes. Airway obstruction due to swollen tonsils may cause mouth breathing, snoring, nocturnal breathing pauses, or sleep apnea. Lethargy and malaise are common. These symptoms usually resolve in three to four days, but may last up to two weeks despite therapy.
- Recurrent tonsillitis: This diagnosis is made when an individual has multiple episodes of acute tonsillitis in a year.
- Chronic tonsillitis: Individuals often have chronic sore throat, halitosis, tonsillitis, and persistently tender cervical nodes.
- Peritonsillar abscess: 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).
What happens during the physician visit?
Your child will undergo a general ear, nose, and throat examination as well as a review of the patient’s medical history. A physical examination of a young patient with tonsillitis may find:
- Fever and enlarged inflamed tonsils covered by pus.
- Group A beta-hemolytic Streptococcus pyogenes (GABHS) can cause tonsillitis (“strep throat”) associated with the presence of palatal petechiae (tiny hemorrhagic spots, of pinpoint to pinhead size, on the soft palate). Neck nodes may be enlarged. A fine red rash over the body suggests scarlet fever. GABHS pharyngitis usually occurs in children 5-15 years old.
- Open-mouth breathing and muffled voice resulting from obstructive tonsillar enlargement. The voice change with acute tonsillitis usually is not as severe as that associated with peritonsillar abscess.
- Tender cervical lymph nodes and neck stiffness (often found in acute tonsillitis).
- Signs of dehydration (found by examination of skin and mucosa).
- The possibility of infectious mononucleosis due to EBV in an adolescent or younger child with acute tonsillitis, particularly when cervical, axillary, and/or groin nodes are tender. Severe lethargy, malaise, and low-grade fever accompany acute tonsillitis.
- A grey membrane covering tonsils that are inflamed from an EBV infection. (This membrane can be removed without bleeding.) Palatal petechiae (pinpoint spots on the soft palate) may also be seen with an EBV infection.
- Red swollen tonsils that may have small ulcers on their surfaces in individuals with herpes simplex virus (HSV) tonsillitis.
- Unilateral bulging above and to the side of one of the tonsils when peritonsillar abscess exists. A stiff jaw, difficulty opening the mouth, and pain referred to the ear may be present in varying severity.
Tonsillitis is usually treated with a regimen of antibiotics. Fluid replacement and pain control are important. Hospitalization may be required in severe cases, particularly when there is airway obstruction. When the condition is chronic or recurrent, a surgical procedure to remove the tonsils is often recommended. Peritonsillar abscess may need more urgent treatment to drain the abscess.