What are Tonsils?

An important part of the lymphatic system, which helps to fight infections, the tonsils are a pair of soft tissue masses located at the rear of the throat or the pharynx. Each separate tonsil is composed of tissue similar to lymph nodes and are covered by pink mucosa similar to that on the adjacent mouth lining. Pits running through the mucosa of each tonsil are known as crypts.

The two most common problems affecting the tonsils are recurrent infections of the throat or a significant enlargement of the glands that might cause nasal obstruction or breathing, swallowing, and sleep problems.

Sometimes, abscesses around the tonsils, chronic tonsillitis, and other such infections of small pockets within the tonsils can even produce foul-smelling white deposits that affect the tonsils and make them severely sore and swollen. Though uncommon, there are also chances for cancers to develop within the tonsils, which would require early diagnosis and aggressive treatment.

Tonsil-Related Conditions

Acute tonsillitis: A bacteria or virus infects the tonsils, causing swelling and soreness of the throat. The tonsil may develop a gray or white coating.
Chronic tonsillitis: Persistent infection of the tonsils usually as a result of repeated episodes of acute tonsillitis.
Peritonsillar abscess: A pocket of pus is created next to the tonsil due to an infection, pushing it toward the opposite side. Peritonsillar abscesses must be drained immediately.
Acute mononucleosis: Usually caused by the Epstein-Barr virus, “mono” causes severe swelling in the tonsils, fever, sore throat, rash, and fatigue.
Strep throat: A bacterium known as Streptococcus infects the tonsils and throat. Fever and neck pain often accompany the sore throat.
Enlarged tonsils: Large or hypertrophic tonsils reduce the size of the airway, making snoring or sleep apnea more likely to occur.
Tonsilloliths: Also known as tonsil stones, which form when trapped debris in the tonsil area hardens or calcifies.


There are several types of tonsillitis as well as numerous possible symptoms, including everything from difficulty swallowing, scratchy sounding voices, high fever, chills, and bad breath, to ear or stomach aches, a stiff neck, and tenderness in the jaw and neck areas due to swollen lymph nodes. Some individuals can even experience increased irritability, poor appetite, and excessive drooling, especially in very young children.


Bacterial infections of the tonsils, especially those caused by streptococcus are often times first treated with a round of antibiotics. Sometimes, the removal of the tonsils (tonsillectomy) may also be recommended if the infections are recurrent despite the use of antibiotic therapy, or if an individual is having difficulty breathing due to enlarged tonsils– as such obstruction to breathing can cause issues such as snoring and disturbed sleep patterns, along with behavioral or school performance problems in children.

Various other treatment options might include abscess drainage, where peritonsillar abscess is generally punctured with a needle to allow the infection to drain and heal.

Post Treatment Care

For those who opt for surgery, there re several post operation details to consider. First, it is good to remember that the amount of benefit gained from having tonsils removed is not yet clear and as with all surgeries, there are several postoperative problems that may arise. These include swallowing problems, vomiting, fever, throat pain, and ear pain. Occasionally, even bleeding from the mouth or nose may occur. It is also important to drink plenty of liquids after surgery to avoid dehydration.

The tonsils function as the body’s first line of defense as part of the immune system. Because they constantly sample bacteria and viruses that enter the body through the mouth or nose, they can often become infected— it is then that they become more of a liability than an asset and may cause serious problems like airway obstruction and repeated bacterial infections.

For more information on ways to keep your tonsils healthy and free from infection, or to seek advice if you suspect that you have a case of tonsillitis, please reach out and contact Dr. Shukla at Sleep MD NYC to get the treatment and care you deserve.

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