Tonsil Inflammation Treatment

On this page, you can find information about the following topics:

Tonsil Inflammation

Tonsil Reduction Surgery

Tonsillectomy

Tonsil Stones (Tonsilloliths)

Tonsil Tumors

Tonsil Inflammation

Tonsils are spherical lymphatic structures located on either side of the throat, behind the uvula. They are part of the immune system and play a role in protecting the body against infections. Inflammation of the tonsils is referred to as tonsillitis.

Tonsillitis is most commonly seen in children over the age of 2.  Before this age, maternal antibodies provide protection, and in adults, it is less frequent due to a more developed immune system.

Tonsillitis is categorized into two types: acute and chronic.

Acute Tonsillitis

This is one of the most common childhood illnesses and is a self-limiting infection that affects one or both tonsils. It is rarely seen before the age of 3 and after the age of 50.

Chronic Tonsillitis

Chronic tonsillitis is defined as recurrent acute tonsillitis episodes occurring at least 7 times in a year or at least 5 times per year over two consecutive years. Its clinical presentation is similar to that of acute tonsillitis. Additionally, the tonsils may appear significantly enlarged. Recurrent tonsillitis episodes can negatively impact the quality of life.

Causes of Tonsillitis

In children, tonsillitis is often caused by beta-hemolytic streptococcus (Group A Beta Hemolytic Streptococcus) or viruses. In some cases, the causative agent cannot be identified. Tonsillitis typically occurs when the body’s resistance is weakened due to factors such as extreme fatigue, poor nutrition, or lack of sleep.  It spreads through direct contact with an infected person or via airborne respiratory droplets.

Symptoms of Tonsil Inflammation

The symptoms of tonsillitis include:

• Burning, stinging, or pain in the throat
• Redness and swelling of the tonsils
• Spots or inflammation on/around the tonsils
• Difficulty and pain while swallowing
• Fever, chills, and shivering
• Fatigue, malaise, and joint pain
• Bad breath
• In cases caused by viruses: runny nose, nasal congestion, sneezing, and coughing
• In children, additional symptoms may include nausea, vomiting, and abdominal pain.

How is Tonsillitis Diagnosed?

Tonsillitis is diagnosed through physical examination, throat culture, or rapid antigen testing. These methods also help identify the underlying cause of the condition.

Treatment of Tonsillitis

The treatment of tonsillitis depends on its cause (virus, bacteria, fungus, or parasite) and may involve antibiotics or other medications.

The goal of acute tonsillitis treatment is to eliminate the infection and alleviate symptoms. Treatment typically includes antibiotics, analgesics (pain relievers), antipyretics (fever reducers), antiseptic gargles, and rest. Incomplete treatment can result in complications such as peritonsillar abscess, middle ear infection, mastoid bone infection, lung infections, rheumatic heart disease, or septicemia.

Tonsil Reduction Surgery

If the tonsils, which are part of the immune system, are abnormally large but do not frequently become infected, and if their size causes issues such as difficulty swallowing, snoring, or sleep apnea, tonsil reduction surgery may be performed. During this procedure, part of the tonsil is left intact. Over time, the remaining portion typically returns to its normal size and continues to function as part of the immune system.

Techniques such as laser, radiofrequency, coblation, or electrocautery are used in tonsil reduction surgeries. There is a minimal risk that the reduced tonsil may grow back to a problematic size.

Tonsillectomy

Tonsillectomy is recommended for the treatment of chronic tonsillitis. The situations in which tonsillectomy is preferred include:

• Frequent tonsil inflammation,
• Recurrence of infection five or more times in one year or three to four times annually for consecutive years,
• Lack of response to applied treatments,
• Persistence of infection for more than three months despite medication,
• Restriction of daily activities,
• Tonsils growing large enough to obstruct the airway,
• Tonsils causing significant swallowing difficulties,
• Speech impairment due to obstruction,
• Severe bleeding from the tonsils.

During tonsillectomy, part or all of the tonsils are removed. Surgery is not performed on children under the age of three unless absolutely necessary.

The procedure is generally performed under general anesthesia for children and local anesthesia for adults. Tonsillectomy can be conducted using various techniques. In the classical method, the tonsils, along with their capsule, are separated from surrounding tissues using a tool called a dissector. Due to the region’s dense vascular structure, bleeding is more common with this technique. Patients typically stay in the hospital for one night.

The latest technique developed for tonsillectomy is the “Thermal Welding Technique”.

Thermal Welding Technique

This method was designed to minimize the risk of bleeding during tonsillectomy. Heat energy is used to separate the tissues, allowing the tonsils to be removed without damaging the surrounding areas. This results in little to no bleeding. Postoperative pain radiating to the ears and throat is significantly reduced. Additional advantages include shorter anesthesia duration, a reduced recovery period from 2–3 weeks to just one week, and quicker resumption of normal eating habits. The elimination of postoperative bleeding risk also prevents the need for secondary interventions and related complications.

Post-Tonsillectomy Period

After a tonsillectomy, patients should adhere to the following guidelines:

• Consume soft, watery foods for one to two weeks post-surgery, and avoid hot foods.
• Choose cold foods like water, milk, and ice cream, and avoid hard, spicy, acidic, and bitter foods and drinks.
• Follow the prescribed medication usage and duration as instructed by the doctor.
• Refrain from consuming alcohol and tobacco products for the period specified by the doctor.
• Adhere to the doctor’s advice regarding travel, physical activity, and sports.
• Children who have undergone tonsillectomy should avoid physical exertion for three weeks.
• Drink plenty of water unless otherwise advised.
• Bathing or showering is permitted anytime after discharge, but the water should be lukewarm. 
• The risk of postoperative bleeding is low, approximately 1–2%. If fresh blood is observed from the mouth or throat or if there is blood in vomit, contact a doctor immediately.

Tonsil Stones (Tonsilloliths)

The tonsils contain small pockets called crypts. Dead cells, mucus, or food debris can accumulate in these pockets, leading to the formation of tonsil stones (magma). These stones can vary in size and are typically white or gray. Their incidence is higher in adults.

Causes of Tonsil Stones

The causes of tonsil stones include:

• Throat infections,
• Tooth infections,
• Nasal secretions,
• Food residues,
• Precipitation of calcium or magnesium salts.

Symptoms of Tonsil Stones

Tonsil stones often do not cause symptoms apart from bad breath. However, in some cases, the following symptoms may occur: 

• A sensation of a foreign body,
• Cough,
• Throat pain,
• Difficulty swallowing.

Preventing Tonsil Stones

To prevent the formation of tonsil stones, consider the following:

• Drink plenty of water.
• Use mouthwash, particularly saltwater gargles, which are beneficial for oral hygiene. 
• Treat throat and nasal infections promptly.
• Chew food thoroughly.

Treatment of Tonsil Stones

Tonsil stones can often be removed without special treatment by gargling with salt water or using a cotton swab. In some cases, they can even be dislodged with the tip of the tongue.

For stubborn, large, or distressing stones, procedures such as curettage, laser treatment, or tonsillectomy may be necessary.

Curettage: Stones are removed using a scraping tool, usually without local anesthesia. However, for larger stones or specific patient conditions, local anesthesia may be applied.

Laser Treatment: The tonsil surface is smoothed through a process called cryptolysis, using a carbon dioxide laser under local anesthesia.  

Tonsil Tumors

Tonsil tumors or cancer are less common than other cancer types and are mostly observed in adults.  Early diagnosis is rare, as the condition is often mistaken for a tonsil infection in its initial stages.

Causes of Tonsil Tumors

The causes of tonsil tumors include:

• Excessive alcohol and tobacco use,
• Genetic factors,
• Poor oral hygiene,
• Inner ear diseases.

In approximately 25% of cases, the cause remains unknown.

Symptoms of Tonsil Tumors

The symptoms of tonsil tumors include: 

• Throat pain,
• Throat swelling,
• Difficulty swallowing,
• Difficulty eating,
• Bad breath,
• Night sweats,
• Rapid weight loss.

Treatment of Tonsil Tumors

If a tonsil tumor is detected, the tonsils and nearby lymph nodes are removed to prevent further spread. If the tumor has already spread to the lymph nodes, radiotherapy and chemotherapy are administered together.