Five fast facts about tonsils and adults

Dr. Philip W. Perlman. (Nov. 8, 2011)

Dr. Philip W. Perlman. (Nov. 8, 2011) Photo Credit: Newsday/Audrey C. Tiernan

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If you're lucky, you'll never give your tonsils a thought. But if you didn't have them removed as a child, be aware that they can flare up in adults, too. Here's what you need to know:





"These days, we're seeing a lot of adults with tonsillitis," said Dr. Philip Perlman, director of otolaryngology, head and neck surgery at St. Francis Hospital in Roslyn. "A lot of them should have had their tonsils out when they were younger."

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The reason they didn't, Perlman said, is that the medical community moved away from performing lots of tonsil-removal surgeries on kids after the 1970s. "It's almost like too few tonsillectomies were done," he said.

Dr. Mark Shikowitz, vice chairman of otolaryngology with the North Shore-Long Island Jewish Health System in New Hyde Park, said he has been seeing a lot of college students who have developed tonsil infections, especially during their first year of living in dormitories, where they're exposed to so many other people. "We have a huge number of young adults who come home after their first semester at college and want their tonsils removed," he said.





Symptoms of tonsil infections include fever, pain, swelling and difficulty swallowing that can be dangerous because of the potential to obstruct the airway, said Dr. Anthony Durante, head of otolaryngology at Winthrop-University Hospital in Mineola. In people with tonsillitis, physicians look for a bright red throat and tonsils, and sometimes little white spots on the tonsils. The tonsils, which are two round clumps of tissue at the back of the throat, filter harmful viruses and bacteria, but this can make them prone to infection, too.




If a viral infection is causing the problem, do-it-yourself treatment often helps: gargling with saltwater, drinking warm liquids, taking over-the-counter medication for fever.

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For bacterial infections, antibiotics are the mainstay treatment. Perlman said doctors typically tackle tonsillitis with penicillin, a combination of amoxicillin and clavulanate (Augmentin) or clindamycin (Cleocin). Durante said people typically get some relief within 48 hours.




Doctors generally stick with antibiotics for those adults who get a couple of tonsil infections a year. "But when you're having three or four that constantly need antibiotics, and you're missing work or missing school, there may be an indication for taking out your tonsils," Perlman said. Surgery also may be necessary for those who have large tonsils that obstruct the airway, causing loud snoring and sleep apnea, he said.

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And, as many people discovered when they were kids, you can do just fine without your tonsils. "You don't really lose the ability to get the protection you're supposed to get from the tonsils," Durante said. In fact, the reason they exist is a bit fuzzy, although they seem to be part of the immune system. "I don't think anyone knows 100 percent why we have our tonsils," Shikowitz said.




In adults, tonsil removal surgery is "a little less painful" than in the past, Shikowitz said. New techniques, like one that uses a tool to shave down the tonsil, have made the adult tonsillectomy "more palatable," he said, no pun intended.

Still, surgery carries a risk for bleeding and complications from general anesthesia, and tonsil removal "is not as simple as people think," Durante said. "We try very hard to not take them out of children and not take them out of adults."

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