John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Medical Author: Melissa Stöppler, M.D.
Medical Editor: William C. Shiel,
Jr, MD, FACP, FACR
Tonsillectomy, the surgical removal of
masses of lymphoid tissue located in the back
of the mouth, may have seemed like a childhood rite of passage for many children
of previous generations. Tonsillectomy became a popular treatment for recurrent
sore throats and respiratory infections as early as the 1800s, and its frequency
peaked in the United States in the late 1950s to the 1970s. Today, doctors are
more conservative in recommending tonsillectomy. The number of tonsillectomies
performed in the United States has declined from over 1 million per year in the
1970s, to about 250,000 per year, due to growing skepticism in the medical
community about the utility of tonsillectomy for infection control.
Often performed in conjunction with removal of the adenoid (a mass of lymphoid tissue
located behind the nasal passages), tonsillectomy is a minor surgical procedure
that is generally well-tolerated. Nevertheless, rare complications such as
infection or bleeding may occur following surgery, and an
absence from school for seven to ten days is usually required.
Bacterial infections of the tonsils and adenoids are
treated with appropriate antibiotics. Viral infections are not.
Tonsillitis and adenoid infections are diagnosed with a history and
physical exam. A rapid
strep test may be ordered in cases of tonsillitis suspected to be
bacterial.
Tonsillectomy and adenoidectomy are indicated as follows: (1) in
persons with repeated or persistent infections; (2) when serious
complications of infection occur; and (3) when enlargement of the
tonsils and adenoids causes breathing, swallowing, or dental problems.
What are the tonsils and adenoids?
The tonsils and adenoids are composed of tissues that are similar to the lymph nodes or glands found in the neck or other parts of the body. Together, they are part of a ring of glandular tissue (Waldeyer's ring) encircling the back of the throat.
The tonsils are the two masses of tissue on either side of the back of the throat. Normal tonsils are usually about the same size and have the same pink color as the surrounding area. On their surfaces are little depressions, called crypts, which may appear deep and contain pus pockets or
tonsil stones.
The adenoids are located high in the throat behind the nose and soft palate (the roof of the mouth) and unlike the tonsils, are not easily visible through the mouth.
A tonsillectomy and an
adenoidectomy (commonly referred to as a T & A) are surgical procedures performed to remove the tonsils and adenoids.
What is the purpose of the tonsils and adenoids?
The tonsils and adenoids are thought to assist the body in its defense against incoming bacteria and viruses by helping the body form antibodies. However, this function may only be important during the first year of life. There is no evidence to support a significant role of the tonsils and adenoids in immunity. Medical studies have shown that children who have their tonsils and adenoids removed suffer no loss whatsoever in their future immunity to disease or ability to ward off infections.
Most sore throats are caused by viruses or mechanical causes (such as mouth breathing) and can be treated successfully at home. However, a person should be seen by a health care professional if they have a sore throat that has a rapid onset, and is associated with a fever or tenderness of the front of the neck; a sore throat that causes the person to have difficulty swallowing (not just pain swallowing) or breathing; or if a sore throat lasts for more than a week.
Strep throat is a sore throat caused by a bacterium called streptococcus (strep) that can be treated through antibiotics. Common symptoms of strep throat include pinkeye, runny nose, skin rash, cough, hoarseness, diarrhea and more. Complications of untreated strep throat include middle ear infections, meningitis, pneumonia, rheumatic fever, and more.
Night sweats are severe hot flashes that occur at night and result in a drenching sweat. In order to distinguish night sweats that arise from medical causes from those that occur because one's surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
The Eustachian tube is a membrane lined tube that connects the middle ear space to the back of the nose. Problems include partial or complete blockage which can cause popping, clicking, and ear fullness. Allergies, sinus and ear infections, or the common cold can cause this blockage, while altitude changes can cause symptoms in those persons with Eustachian tube problems. Treatment includes several maneuvers (swallowing, chewing gum, yawning etc.), which can be done to improve Eustachian tube function.
Middle ear infection or inflammation (otitis media) is inflammation fo the middle ear. There are two types of otitis media, acute and chronic. Acute otitis media is generally short in duration, and chronic otitis media generally lasts several weeks. Seventy-five percent of children in the U.S. suffer from otitis media at some point. Treatment depends upon the type (chronic or acute).
Snoring, like all other sounds, is caused by vibrations that cause particles in the air to form sound waves. While we are asleep, turbulent air flow can cause the tissues of the nose and throat to vibrate and give rise to snoring. Any person can snore. Snoring is believed to occur in anywhere from 30% of women to over 45% of men. People who snore can have any body type. In general, as people get older and as they gain weight, snoring will worsen. Snoring can be caused by a number of things, including the sleep position, alcohol, medication, anatomical structure of the mouth and throat, stage of sleep, and mouth breathing.
Snoring, like all other sounds, is caused by vibrations that cause particles
in the air to form sound waves. For example, when we speak, our vocal cords
vibrate to form our voice. When our stomach growls (borborygmus), our stomach
and intestines vibrate as air and food move through them.
While we are asleep, turbulent airflow can cause the tissues of the nose and
throat to vibrate and give rise to snoring. Essentially, snoring is a sound
resulting from turbulent airflow that causes tissues to vibrate during
sleep.
How common is snoring?
Any person can snore. Studies estimate that 45% of men and 30% of women
snore on a regular basis. Frequently, people who do not regularly snore will
report snoring after a viral illness, after drinking alcohol, or when taking
some medications.
People who snore can have any body type. We frequently think of a large man
with a thick neck as a snorer. How...