Throat

Tonsillitis

Tonsillitis occurs when the tonsils become inflamed from infection. Tonsils and adenoids may cause problems if they become enlarged or infected. Tonsillitis is most commonly seen in children between the ages of 6 and 8. There are many causes of tonsillitis (viruses, bacteria, fungal infections). Cigarette smoke may increase incidence of tonsillitis. Symptoms of tonsillitis may include: sore throat, fever, headache, decrease in appetite, not feeling well, nausea, vomiting, stomach aches and painful swallowing. If tonsils are very large periods of apnoea (stopping breathing) may occur at night.

Adenoiditis

Adenoiditis is an inflammation of the adenoids due inflammation or infection. Symptoms of adenoiditis or enlarged adenoids may include: mouth breathing, noisy breathing or snoring, nasal speech, or if very large periods of apnoea may occur at night. Specific treatment for tonsillitis and adenoiditis will be determined based on: age, general health and medical history; severity and frequency of infections; the occurrence of any airway problems; and your opinion or preference.

Surgery for Tonsillectomy & Adenoidectomy

In children the tonsils and adenoids are frequently removed at the same time, but sometimes, only one is removed. Tonsillectomy and adenoidectomy (T&A) surgery is one of the most common major operations performed on children. The most common reasons for performing tonsillectomy and adenoidectomy are recurrent tonsillitis (not just a sore throat) and/or airway obstruction causing problems with breathing.

Written by Dr Zoran Becvarvski, ENT specialist

What is sleep apnoea?

Paediatric obstructive sleep apnoea (or a “newer term” sleep disordered breathing) in children is a medical condition in which children have breathing problems while they are asleep. Sleep apnoea can affect children’s sleep and behaviour, and if untreated can lead to more serious problems. When children (and adults) fall asleep, the muscles in the upper airway relax and become floppy. These can be partially or totally blocked by large tonsils and adenoids while the child is asleep. Snoring in children is common (15-20%) however, obstructive sleep apnoea is less common. It affects approximately 2-3 children in every 100.

What are the main symptoms of sleep apnoea?

Sleep apnoea may be difficult to diagnose, thus is it important to look for the following symptoms:

• Snoring
• Laboured breathing during sleep
• Excessive Sweatiness AND/OR Restlessness during sleep
• Excessive day time Sleepiness AND/OR morning Tiredness/Headaches
• Pauses in breathing AND/OR “Choking”/Gasping/Snorting during sleep
• Awakening due to bad dreams (“parasomnias”) AND/OR sleep walking
• Positions (sleeping in unusual positions; eg extended neck, sitting up)
• Nasal obstruction and mouth breathing
• Overweight or Underweight
• Enuresis (bedwetting)
• Attention/learning/behavioural problems

How is obstructive sleep apnoea treated?

Enlarged tonsils and adenoids are a common cause, thus dissection tonsillectomy and curettage adenoidectomy are performed to treat this problem. Allergic rhinitis/nasal obstruction is treated with medication (+/- surgery). Obese and overweight children are started on exercise and weight management programs.

Written by Dr Zoran Becvarvski, ENT specialist