At some point, almost every child in the United States will have at least one episode of tonsillitis. This is the most common form of bacterial pharyngitis, especially in school-aged children. This bothersome and often painful condition occurs when the palatine tonsils, which are lymphoid (antibody producing) organs on the side of the throat, become inflamed due to a viral or bacterial infection.

Types Of Tonsillitis And Associated Symptoms

Acute tonsillitis – Symptoms typically include fever, sore throat, bad breath, difficulty swallowing, and painful swallowing. Sometimes the patient develops mouth breathing, snoring, sleep apnea, a “scarlatina” rash (scarlet fever), and a feeling of lethargy. These symptoms can last from three days up to two weeks. By definition, acute tonsillitis lasts for less than four weeks, and typically each episode responds well to oral antibiotics and hydration of the patient.

Recurrent tonsillitis – When a patient has multiple episodes of acute tonsillitis (see above symptoms) in a single year, he or she is said to have recurrent tonsillitis. Typically, an ENT doctor will be consulted after a patient experiences five to six episodes of acute tonsillitis in a 12-month period.

Chronic tonsillitis – Symptoms include chronic sore throat, bad breath, tonsillitis, and persistently tender cervical nodes. This condition is often associated with a related condition called tonsillar cryptitis with or without cryptic debris. This refers to chronic infection of the pockets of the tonsils with or without a buildup of organic material, sometimes inaccurately called “tonsil stones” (or tonsilloliths). Tonsil stones and chronic tonsillitis are among the most common reasons adults seek to have their tonsils out.

Peritonsillar abscess – Severe throat pain, fever, drooling, foul breath, difficulty opening the mouth (trismus), and muffled voice quality are typical symptoms of a patient with a peritonsillar abscess. This condition is extremely uncomfortable and develops rapidly over a few days, often in patients with no prior history of tonsillitis. Patients with a peritonsillar abscess invariably have pain much worse on one side of the throat than the other. This can be true for acute tonsillitis, but not as predictably so. If suspicious of a peritonsillar abscess, the patient should seek emergency or ENT care immediately.

Treatment Of Tonsillitis

Antibiotics are the standard initial treatment for most forms of tonsillitis. If the problem is chronic or recurrent, a tonsillectomy, or surgery to remove the tonsils (usually with the adenoids as well, which are simply tonsils in the back of the nose), is often recommended. In the case of peritonsillar abscess, drainage via incision or needle aspiration is almost always necessary. Historically, electrical cautery has been the most common method for the removal of tonsils. However, this process burns the tissue at very high temperatures, effectively creating a third-degree burn in the throat of the patient and subsequently thick eschar (scabs) that must heal.

At CornerStone Ear, Nose & Throat, we exclusively use a Coblation® device, as opposed to using an electrocautery device or cold steel knife, to make an incision to cut away the tissue. The Coblation procedure typically results in much less risk of bleeding and pain for the patient. This is largely because while the electrocautery device operates at several hundred degrees Celsius (and leaves a third-degree burn in the throat), the Coblation device works at about 70 degrees Celsius under constant cool saline (saltwater) irrigation. With Coblation, the tissue is cut and cooled simultaneously, avoiding a deep thermal burn, which would be more likely to lead to dehydration and bleeding during the healing process. This allows patients to tolerate fluids and food more quickly, while allowing them to recover in less time with fewer complications and less discomfort, according to multiple published studies as well as our practice’s lengthy experience performing the procedure.