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Tonsils & Adenoids Surgery


The tonsils are collections of lymph tissue located at the back of the mouth. They are composed of special cells that help fight infection. Small pits are present on the surface, and these extend down into the tissue forming small tubes known as “crypts”.

The tonsils that typically cause tonsillitis are called the pharyngeal tonsils.

There are other groups of the same tissue nearby, including the lingual tonsils in the back of the tongue and the adenoids at the back of the nose.


The adenoids are a collection of tissue above the soft palate at the back of the nose.

Respiratory viruses are more likely to infect the adenoids first because they are located at the back of the nose.

Tonsils and adenoids can be safely removed, as they form only a very small part of the body’s total immune system. If they are diseased, after they are removed the immune system actually functions in a more healthy way.

You can read more about what is involved in removing the adenoids through surgery here.


Tonsillitis is inflammation of the tonsils in the mouth (the pharyngeal tonsils). It is usually caused by a viral infection, but can also be caused by bacteria. It is usually impossible to tell the difference between a viral or bacterial infection by looking at the tonsils. The adenoid tissue located at the back of the nose or the lingual tonsils at the back of the tongue may become infected at the same time.

The symptoms of tonsillitis include sore throat, difficulty swallowing, bad breath, fever, swollen neck glands, loss of appetite, change in voice and fatigue. The tonsils generally become red and swollen and may have pus visible on the surface of the small pits of the tonsil.

Most people suffer from tonsillitis at some point in their lives. Young children are most commonly affected, as their immune systems are still developing.

Types of tonsillitis

Acute tonsillitis

  • Patients have a fever, sore throat, foul breath, painful swallowing and tender neck glands.

Recurrent tonsillitis

  • Patients who have more than one attack of acute tonsillitis per year have recurrent tonsillitis.

Chronic tonsillitis

  • Patients who have had either repeated attacks or a very severe attack of tonsillitis can develop chronic tonsillitis. A low-grade bacterial infection continues to cause problems within the tonsil tissue. Excessive scarring often leads to the build-up of old food, dead cells and bacteria within the tonsil crypts. This can cause a range of symptoms including pain, bad breath, tonsil stones and fatigue.

Peritonsillar abscess (quinsy)

  • Very severe tonsillitis can lead to a collection of pus forming between the capsule of the tonsil and the muscle of the throat. This usually needs to be drained. Significant scar tissue can be left behind, and a small cavity can form leading to repeated episodes of abscess formation.

Sleep disordered breathing in children (snoring, sleep apnoea)

Tonsillectomy or Adenotonsillectomy

The decision to have surgery needs to consider a number of factors. These include:

  • The frequency and severity of infections
  • The history of antibiotic use and effectiveness
  • The severity of symptoms
  • Other complicating illnesses
  • The effect on schooling or work
  • The presence of sleep disordered breathing (snoring, sleep apnoea)

Dr Roth performs tonsil and adenoid surgery using the very latest techniques. This includes the use of diathermy and coblation techniques. He has a special interest in developing and refining techniques that minimise post-operative pain in children.

You can read in more detail about what is involved in a tonsillectomy or adenotonsillectomy here.

Before and After Photos Sydney