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Have you ever caught sight of the small bumps in your throat? Those protuberances are tonsils and play a crucial role in protecting our body from infections.
A 2023 research, titled Anatomy, Head and Neck: Adenoids, led by Dr Ani Mnatsakanian and her team, found that the tonsils tissue helps the body create B cells and T cells. These are special white blood cells that fight infections and keep us healthy.
Dr Jyotirmay S Hegde, lead consultant and head, Department of ENT at Aster Whitefield Hospital in Bengaluru, explains that tonsils are small tissue masses that assist the body in fighting infections. “They prevent infections by stopping germs from getting into the body through your mouth and nose,” he says.
Three main types of tonsils
Each type is important for defending the body against harmful pathogens and maintaining our overall health.
But these tonsils sometimes get infected due to several reasons, such as viral or bacterial invasions leading to tonsillitis, where the tonsils become inflamed and swollen. Happiest Health explores different types of tonsils, their importance, and how to handle inflammation.
1. Palatine tonsils
They are located on both sides of the back of the throat (oropharynx) and are visible through the mouth. Their function is to help our body fight germs that get in through the mouth and nose. They do this by making special proteins called antibodies that stop the bad germs.
Causes: Palatine tonsils can become inflamed due to viral or bacterial infections, commonly known as tonsillitis. These infections can be caused by pathogens like streptococcus bacteria or viruses such as the Epstein-Barr virus (EBV).
Diagnosis: Doctors diagnose tonsillitis by examining the throat, checking for redness, swelling and pus on the tonsils. They may also perform a throat swab for laboratory testing to identify the specific pathogen causing the infection.
Treatment: Treatment of tonsillitis depends on the underlying cause. Viral infections usually resolve on their own with rest, hydration and over-the-counter pain relievers. Bacterial infections may require antibiotics prescribed by a healthcare professional.
2. Pharyngeal tonsils (adenoids)
The pharyngeal tonsils, or the adenoids, are situated at the back of the nasal cavity — which is at the top of the throat, behind the nose, and above the soft palate. They are not visible like the other tonsils. The adenoids help our immune system by acting as an air filter that filters out bacteria as you breathe in the air. Protruding teeth, crowding teeth and an open mouth are some of the signs of pharyngeal tonsils.
Enlarged adenoids can also cause similar symptoms, including nasal congestion and breathing difficulties. Adenoid hypertrophy, where the adenoids become excessively enlarged, can obstruct the airway, particularly during sleep. Rare, adenoid cystic carcinoma is a form of cancer that can affect the adenoids.
Causes: Dr Apoorva Reddy, senior ENT specialist at Kamineni Hospitals, Hyderabad, mentions that problems with adenoids can include inflammation called adenoiditis. This swelling is usually caused by infections from bacteria or viruses, causing symptoms like a sore throat, trouble breathing through the nose and ear infections.
“Enlarged adenoids can also cause similar symptoms, including nasal congestion and breathing difficulties. Adenoid hypertrophy, where the adenoids become excessively enlarged, can obstruct the airway, particularly during sleep,” she says. In rare cases, a type of cancer called adenoid cystic carcinoma can affect the adenoids.
Diagnosis: Diagnosis of adenoid hypertrophy can be made by one’s history, diagnostic nasal endoscopy where the adenoids can be visualised in the nasopharynx, and X-ray nasopharynx (with a lateral view) showing soft tissue opacification (the process of becoming cloudy or opaque). Eustachian tube block and ear infections associated with adenoid hypertrophy can be diagnosed with an impedance audiometry test.
Treatment: Medical treatment includes using antihistamines, nasal sprays with steroids, decongestant nasal drops, and antibiotics for severe infections. A surgical option of removal called endoscopic adenoidectomy will be required if medical treatments do not work or if the adenoids are highly swollen, blocking over half of the nasal passage. If there is also an ear infection, a procedure called bilateral myringotomy with grommet insertion will be necessary.
3. Lingual tonsils
Lingual tonsils are one of the three types of tonsils which has tiny lumps of lymphoid tissue found under the tongue. When infected, the lingual tonsils can cause various symptoms like sensitivity in the neck area, bad breath, pain while swallowing and a sore throat. “Sometimes the inflammation can block the airway and make it hard to breathe, especially when sleeping. This might cause snoring or sleep apnoea,” says Dr Hegde. The affected individual can also suffer from chills, body aches and fever. While they are not as visible as palatine tonsils, they still play a role in protecting the mouth from various illnesses.
Causes: Lingual tonsils can become inflamed due to infections, such as viral or bacterial infections, or as a result of irritation from gastric reflux or smoking.
Diagnosis: Lingual tonsils rarely get affected, but when they do, it can be quite challenging to diagnose as there is limited visibility. It is usually diagnosed by swab tests and blood tests, but lately, laryngoscopy is also used. Laryngoscopy helps in getting a better view of the affected area, helping in spotting potential redness or inflammation.
Treatment: The condition can be cured by keeping oneself hydrated and getting adequate rest, along with taking common pain relievers. However, in the case of a bacterial infection, one must take antibiotics as prescribed by a healthcare professional.
Home remedies to manage tonsillitis
Keeping oneself hydrated is the most important tip. Drinking liquid foods such as soups and broths can help ease the discomfort in the throat. Gargling salted warm water or apple cider vinegar mixed in warm water can reduce inflammation if done a few times a day. “Sipping herbal teas with mint, raw honey or ginger can help soothe your throat and reduce infection,” recommends Dr Hegde.
Preventive actions
Frequent tonsillitis can be avoided by avoiding cold food and drinks, exposure to cold, washing hands before eating and avoiding spicy and junk food. Regular visits to a healthcare provider for check-ups and prompt treatment of any throat-related symptoms can also help in the early detection and management of tonsil issues.
Understanding these types of tonsils and its causes, diagnosis, treatment options for different conditions empowers individuals to proactively maintain throat health. However, for any persistent or severe throat symptoms, one should consult a healthcare professional for its evaluation and appropriate treatment.
