Your physician will ask about problems of the ear, nose, and throat, and examine the head and neck. They may use a small mirror or a flexible lighted instrument to see these areas. Other methods used to check tonsils and adenoids are:
- Throat cultures or strep tests to identify infections in the throat
- A small, flexible scope to visualize the size of the adenoids; an X-ray may also be ordered
- Blood tests to diagnose infections such as mononucleosis
- Sleep study, or polysomnogram, to help decide whether sleep apnea is present and if sleep disturbance may be due to enlarged tonsils and adenoids
Bacterial infections of the tonsils, especially those caused by streptococcus, are first treated with antibiotics. Tonsillectomy, removal of the tonsils and/or adenoids (adenoidectomy), can be an option when infections return frequently even after antibiotic therapy or there is difficulty breathing with the enlarged tonsils and/or adenoids.
Frequent infections of the adenoids can affect other areas such as the ear’s passage between the back of the nose and the inside of the ear, known as the eustachian tube. This can lead to frequent ear infections and collection of fluid in the middle ear that may cause temporary hearing loss. Removal of the adenoids may help some children with chronic earaches accompanied by fluid in the middle ear (called otitis media with effusion).
In adults, the possibility of cancer or a tumor may be another reason for removing the tonsils and adenoids. In some patients, especially those with infectious mononucleosis, severe enlargement may obstruct the airway. For those patients, treatment with steroids (e.g., prednisone) is sometimes helpful.
Learn more about how to prepare for tonsil and adenoid surgery.