“Hey, my doc says I need a T&A.”
“What? You need
T&A? He actually said that? Is he a pervert?”
“No, no! It’s a
Tonsillectomy and Adenoidectomy. I need
my tonsils and adenoids removed.”
“Oh. I thought you
and he were a couple of crude males. By
the way, what are adenoids and where are they?”
Good question and a common one at that. Tonsils and adenoids are lymphatic tissues
that are part of your body’s defenses, the immune system. They secrete antibodies that fight foreign
invaders like bacteria and viruses and the like. They’re more important during early childhood,
and as one ages, they become rather unnecessary as the rest of the immune
system takes over.
Tonsils are those things in the back of the throat, one on
each side. Most folks are familiar with
these guys since they’re visible in most people.
As for the adenoids however, these reside way in the back of the nose,
above the soft palate and that dangling thing in the middle called a
uvula. The adenoid is a single, midline mass of tissue; thus, we have just one adenoid, so to speak. The drawing at top shows a side, cut-out view (sagittal view in technical lingo). Thus, they’re hidden from view.
So how do you assess adenoids? Most doctors cannot see the adenoids. On occasion, one may see the bottom edge way
behind the uvula. An ENT doctor can
sometimes visualize these with a dental mirror (Figure 1), providing there is adequate space
and the patient doesn’t gag and barf all over the poor doc.
 |
| Figure 1 |
They can be visualized using a fiberoptic scope through the
nose. Most teenagers and adults tolerate
this quite well, but for young kids…there’d be a whole lot of kicking and screaming.
One of the easiest methods is a single
x-ray taken from the side of the head. The
adenoid and its size are easily assessed (Figure 2).
Later, at another posting, we’ll get into the indications
for removing the adenoids, but this should serve as a primer on some rudimentary
anatomy.
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| Figure 2 |
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