Adenotonsillitis – Symptoms, Risks, Diagnosis, and Treatment

Adenotonsillitis is a condition caused due to the inflammation of the tonsils and adenoids.

Tonsils are two small round lumps present at the back of the throat whereas adenoids are situated high in the throat, behind the roof of the oral cavity (the soft palate), and the nose.

Tonsils and adenoids form a part of our immune system. They help to protect the body against diseases, especially infections. Unfortunately, when tonsils and adenoids get infected or inflamed, they become swollen due to which patients may develop a range of symptoms like pain in the throat and a difficulty in swelling.


How does age influence the risk of adenotonsillitis?

Infection in the tonsil and adenoid is very common. Adenotonsillitis usually affects children. The higher incidence of Adenotonsillitis in children could be attributed to the fact that when children start going to a nursery or school, they meet other children and play with them. This can expose them to respiratory infections more frequently putting them at a risk of adenotonsillitis as well as other infective conditions.

In 90% of children, the adenoids begin to shrink as age increases. The size of adenoids reduces markedly after 12 years of age. Hence, the incidence of adenotonsillitis or adenoiditis is extremely low in children after 12 years of age.

However, tonsils, in contrast, remain in the throat throughout our life with minimal shrinkage as compared to the adenoids. Hence, the risk of tonsillitis persists throughout our life. Patients may develop tonsillitis at any age, although the risk tends to decline gradually with age, possibly due to the build-up of immunity.


What are the symptoms of adenotonsillitis?

The symptoms of adenotonsillitis include the symptoms caused due to the inflammation of the adenoids (adenoiditis) and inflammation of the tonsils (tonsillitis).

Symptoms of adenoiditis

  • Breathing through the mouth
  • Sounds from the blockednose while speaking
  • Noisy breathing during the day
  • Chronic runny nose
  • Recurrent ear infections
  • Earache
  • Restlessness during sleep
  • Repeated pauses while breathing while sleeping
  • Snoring at night

Symptoms of tonsillitis

  • Enlargement of the tonsils
  • Obstruction of the oral route
  • Sore throat
  • Presence of pus or exudates on the tonsil
  • Pain while swallowing
  • Fever
  • Swelling of the lymph nodes in the neck
  • Snoring

A condition that causes the enlargement of the tonsils with abscess formation is called a peritonsillar abscess. Most patients in the paediatric age group present with adenotonsillitis while patients in the adult age group usually present with tonsillitis alone.

You can attend our AARC Approved CEUs to learn more about the symptoms of adenotonsillitis and the most effective ways to treat this condition.


What are the causes of adenotonsillitis?

Adenotonsillitis is usually caused due to common viruses, although bacterial infections can also cause this condition.

The most common bacterium known to cause tonsillitis and adenoiditis is Streptococcus pyogenes. It is the same bacterium that also causes strep throat. Some other strains of Strepcocci can also cause adenotonsillitis.

Why do adenoids and tonsils get infected?

The tonsils and adenoids form the first line of defence of the body against bacteria and viruses entering it through the mouth. This function makes the tonsils and adenoids more vulnerable to inflammation and infection.

However, the immune system functions of the tonsils tend to decline after puberty, which is one of the reasons why the cases of tonsillitis are rare in adults.

What are the risk factors of adenotonsillitis?

Young age: Adenotonsillitis usually affects children. Tonsillitis caused due to bacteria is more common in children between the ages of 5 and 15 years.

Exposure to germs: Young children going to school are more likely to come in close contact with other children and hence, have a higher risk offrequentexposure to viruses or bacteria. The frequent exposure to germs in school-age children makes them more vulnerable to developing this condition.

Our respiratory webinars for nurses are aimed at providing detailed information about the causes and risk factors of adenotonsillitis. Doctors, nurses, and other healthcare professionals can attend our seminars to learn the latest treatment methods for managing this condition.

Diagnosis of adenotonsillitis

Infection and inflammation in the tonsils can be detected with the help of direct visual throat examination. The presence of pus or exudates on the tonsil could indicate active infection. The examination may also reveal the enlargement of the tonsils.

Based on the size of the tonsils and the level of obstruction to the oral route, the grading of the tonsillar swelling can be done.

It is difficult to detect infection and inflammation in the adenoids, as these lumps are located behind the nose, and hence, are not visible on direct visual examination.

The physician may recommend an x-ray nasopharynx and diagnostic paediatric nasal endoscopy for confirming the diagnosis of tonsillitis and adenoiditis. The test can detect the presence of the adenoid mass at the back of the nose causing obstruction to the nasal route.

Management of adenotonsillitis

The symptoms of adenotonsillitis can be relieved with medications including antibiotics, antihistamines,anti-allergic nasal sprays, and decongestant nasal drops.

A surgery for the removal of the tonsils called tonsillectomy is often recommended for patients who suffer from recurring episodes of tonsillitis.

Adenotonsillectomy is recommended for patients who suffer from adenotonsillitis. The surgery usually takes about 30 minutesand is performed under general anesthesia.

A surgeon may use electrocautery that involves the exposure of the affected tissues to heat to assist in the removal of the tonsils and stop bleeding. The cold knife dissection method can be used for the removal of the tonsils with a scalpel followed by sutures or electrocautery to stop the bleeding.

Some other methods include a carbon dioxide laser, radiofrequency ablation techniques, and a microdebrider.


Adenotonsillitis is a common infective and inflammatory condition affecting children. Doctors and other healthcare professionals can attend our Respiratory Therapy Conference to learn the symptoms, causes, risk factors, and the various treatments for this condition. This will help you offer the best treatments to your patients thus improving the outcomes.