Painful tonsils can keep children and their parents awake at night. How to recognize this condition and where to seek help? Dr. Piotr Pastuszek, MD, otolaryngologist from NZOZ "Twój Lekarz" suggests.

Enlarged and painful tonsils in children are clusters of lymphatic tissue containing cells adapted to fight foreign microorganisms. During an infection, the immune system is mobilized, which is why when we are sick, our tonsils can enlarge, sometimes reaching significant sizes, which does not always indicate their pathology. However, parents should be alerted to a situation in which enlarged tonsils become chronic and are accompanied by very unpleasant and tiring ailments for the child.

Ailments that worry

The most important period of maturation of the immune system falls on the first years of a person's life, which is why the topic of tonsils is particularly important in children. However, it may turn out that before they gradually begin to disappear, they will cause unpleasant symptoms, such as:

• slurred speech
• persistent, periodic sore throat
• feeling of an obstruction in the throat
• unpleasant taste in the mouth
• neck pain
• difficulty swallowing
• recurrent tonsillitis
• mouth slightly open
• snore
• mouth breathing
• problems with concentration
• headaches
• worse hearing
• frequent ear and upper respiratory tract infections

All of the above symptoms should prompt the parent to visit an ENT specialist with their child.

How to diagnose?

During a visit to a primary care physician, only the palatine tonsils can be assessed. They are composed of narrow slits, which means they come into contact with pathogens over a much larger surface area than might appear at first glance. This has certain consequences. The openings of these slits can become clogged, creating conditions for microorganisms to thrive and, consequently, chronic tonsillitis. Suspected hypertrophy of the so-called "third" pharyngeal tonsil requires a visit to an otolaryngologist, as the examination requires specialized equipment. The otolaryngologist performs the examination using a mirror inserted into the throat or an endoscope—a special camera that allows for precise visualization of the tonsil structures.

How to treat?

The most common solution to the problem of tonsillar hypertrophy, chronic inflammation, recurrent tonsillitis or peritonsillar abscesses is to remove them or, as in the case of palatine tonsils, possibly to cut them. Such procedures are usually performed on children who are over 5 years old.