Tonsils are lymphatic tissue on the side of the throat behind the tongue and beside the uvula.They produce antibodies to fight infection
Adenoids are behind the nose above the level of the soft palate. They can be regarded as a third tonsil as they are the same lymphatic tissue and their job is the same.
When you might need to consider ENT Surgery: Tonsillectomy with or without adenoidectomy is needed if the bouts of tonsillitis are frequently making a child sick.(Recurrent acute tonsillitis). A quinsy is an abscess between the capsule of the tonsil and the muscle of the throat. It usually makes a patient unwell enough to be in hospital for IV antibiotics and surgical drainage. Most patients who have had a quinsy do not want another and choose tonsillectomy sugery.
Chronic tonsillitis is a lower grade but more irritating and persistant form of tonsillitis. It is more common in young adults.
Glandular fever tonsillitis is also more common in young adults and can cause severe swelling of the tonsils and may even cause difficulty breathing
Sleep disordered breathing... (Upper airway resistance syndrome and obstructive sleep apnoea). In children the tonsils and adenoids are the main source of airway obstruction. If left it can lead to pulmonary hypertension. Other symptoms are bedwetting, slow growth, headache, poor concentration, bad behaviour and ill temper. This is a good indication for removal of large tonsils even if there have not been infections.
The ENT Surgeon... will remove the tonsils under a general anaesthetic. The adenoids are first removed with a curette behind the palate. The tonsils can be removed with scalpel, scraping instruments, electric diathermy, or coblation.Coblation is cold ablation of tissue ... a plasma wand dissects soft tissue when held just above the tissue. It is not a laser. Laser tonsillectomy is generally not done in Australia. It is too difficult to set up, potentially dangerous with burns, and causes more charring and post op scarring.
Dr Forrest likes the coblation technique because in his experience, patients have a less painful recovery. Unfortunately few health funds will cover the use of coblation but if you are interested in this technique please ask Dr Forrest