What are tonsils?

The tonsils are two clumps of immune tissue located in the throat. They contain cells that fight infection and help defend the body from germs which enter the mouth and nose. Tonsils vary a lot in size- in some people they can be very small- so small in fact it may be hard to see them, while others may have quite large tonsils.

Because most cases are viral, antibiotics are not usually recommended.

If it is bacterial tonsillitis, the symptoms may be a bit more severe, and your doctor may be able to confirm the diagnosis with a throat swab. Some special throat swabs can give you a result on the spot- indicating whether it’s a viral or bacterial infection. This is useful, as it may help to avoid an unnecessary course of antibiotics.

If it is bacterial, the bug is almost always Streptococcus (that’s why people call it a “strep throat”), and a 10 day course of antiobiotics is the standard treatment.

If you have concerns about enlarged tonsils, recurrent tonsillitis or other problems, speak to your doctor.

What is Glue Ear?

• Glue Ear is when the middle ear fills up with with sticky fluid instead of air, over a period of weeks or months
• The middle ear is the air-filled central chamber of the ear, behind the eardrum.
• Over time, Glue Ear can lead to reduced hearing, speech problems and discomfort.
• While it usually gets better by itself, sometimes surgical treatment with ventilation tubes (grommets) is needed if a child’s hearing or speech is being affected.

How common is Glue Ear?

It’s thought to affect about 80% of kids before the age of 10, though it’s most common from 2 to 5 years of age. Most children grow out of it over time.

Grommet insertion- what does it involve?

• It’s usually a straight-forward operation, and generally doesn’t necessitate an overnight hospital stay
• The child will have a General Anaesthetic, which does pose some health risks- it’s important to ask your doctor about these
• A tiny surgical cut is made in the eardrum, fluid may be drained from the middle ear, and a ventilation tube (grommet) is inserted, which sits in the eardrum.
• Grommets tend to naturally fall out after 6-12 months, and the hole in the eardrum usually heals up quickly.
• Some kids may need to have grommets reinserted if Glue Ear comes back.
• While grommets are in place, it’s still OK for child to swim (they don’t need earplugs), though diving is discouraged. Air travel is also fine.

If you have further questions about Glue Ear, otitis media or grommets, speak to your GP.

If you’ve ever had the sensation that your ears are blocked, or you feel you need to pop them but they just won’t pop, you may have had “Eustachian Tube Dysfunction”. It’s a common problem, and one that often brings people to see the doctor. So, what are Eustachian Tubes, what’s their role and what causes them to misbehave?

What are the Eustachian Tubes?

• The Eustachian Tubes are thin channels or tubes that connect the middle ear (the part of the ear behind your eardrum) to narrow openings high up in the back of the throat, behind your nose.
• The purpose of these tubes is to equalise the air pressure in the middle ear with the air outside, and to allow any fluid or mucus in the middle ear to drain away.
• Normally, the Eustachian Tubes open for an instant when you chew, swallow, yawn, or if you purposely pop your ears by blowing out against a tightly closed mouth and blocked nose. Usually, you’ll hear a little clicking sound as the Eustachian Tubes open and shut.

What causes Eustachian Tube Dysfunction?

There are several health issues that can trigger Eustachian Tube Dysfunction, including:

• Head colds or other respiratory viruses- mucus blocks the tubes or the place where they open into the back of the throat
• Sinusitis-a postnasal drip occurs when there is mucus flowing down from the back of the nose, into the throat. This mucus may cover the opening of the eustachian tubes.
• Hay fever or other allergic rhinitis – again, mucus production can lead to blockage of the tube openings
• Anything that causes rapid changes in air pressure and/or altitude- e.g. air travel, climbing mountains, using an elevator in a tall building.
• Smoking- this irritates the airways and the “cilia” which are tiny protective hair-like structures that clear out the middle ear.
• Obesity- fatty deposits may cause congestion around the eustachian tubes

When should you see a doctor?

If your symptoms continue for more than 2 weeks or so, you should see your doctor for a check-up. However, if you develop symptoms such as severe earache, headaches, dizziness, vomiting, fever, dramatically reduced hearing, or if you feel particularly unwell, you should seek immediate medical attention.

What else causes blocked ears?

There are other conditions that can lead to a sensation of blocked ears, including:

• Ear wax
• Middle ear infection (otitis media)
• Infection of the outer ear canal (otitis externa or swimmer’s ear)
• Very rare causes such as tumours or stroke

If you have blocked ears, or other symptoms relating to your ears, you should speak to your doctor.

What are adenoids?

• The adenoids are fleshy lumps of immune tissue located in the back of the nose in children.
• Their job is to fight infection, the same as lymph nodes (glands) elsewhere in the body.
• Hairs and mucus in the nose trap viruses and bacteria that are breathed in- and the adenoids make antibodies and white cells that destroy these germs.
• Adenoids cannot be seen when you look into your mouth or throat (though you can see your tonsils, which perform a similar job)
• In smaller children, adenoids play a very active role in fighting infection, but as the immune system matures, they are less important. They tend to shrink through childhood, and may be completely gone by the time the teens are reached.