Palatine tonsils and adenoid are part of the lymphatic tissue of the throat referred to as Waldeyer’s tonsillar ring. It is an area where organism contacts in a controlled manner with pathogenic and antigen environment. In the early childhood, intensive stimulation of immunological system occurs in the tonsils which is reflected by their growth being at that time a physiological and desired phenomenon.
However, tonsils of some children grow excessively and reach the level at which substantial narrowing of the upper respiratory tract with harmful consequences to the rest of the body. Difficulties in breathing through the nose triggers formation of malocclusion, result in sleep apnoea and more frequent infections of upper respiratory tract. Adenoid hypertrophy often impairs the function of auditory tubes which results in emergence of fluid in the tympanic cavities and related hearing impairment. It may also impair speech and swallowing.
Furthermore, due to constant exposure to pathogens, tonsils may in unfavourable conditions be colonised by them and change from a part of immune system to the source of recurring infections. In such case, inflammation may cover not only the tonsils themselves but also the middle ear and paranasal sinuses.
In all cases described above, it is justifiable to remove the tonsils despite possible unfavourable immunological effects. It should be however taken into consideration that palatine tonsils and adenoid are one of many elements of lymphatic system of the throat and its normal functioning is possible without them.
- Adenotomy (removal of adenoid) is a surgery performed mainly in children which consists of removal of the overgrown lymphatic tissue from nasal part of the throat to improve nasal patency, unblock auditory tubes and decrease susceptibility to upper respiratory tract infections. The procedure is performed under general anaesthesia.
- Tonsillectomy (removal of palatine tonsils) consists in bilateral removal of palatine tonsils through the mouth. In children, it is often performed together with adenotomy.
- Tonsillotomy (partial removal of palatine tonsils) consists in removal of the overgrown parts of palatine tonsils which extend beyond palatal arches. Tonsillotomy is mainly performed in children with overgrown tonsils, which are not inflamed.