Tonsils and Adenoids
Enlarged Tonsils and Adenoids
- When the tonsils and adenoids are enlarged, the airway can be significantly compromised which can make it difficult to breath through the nose and create the need to breathe through the mouth.
- Mouth breathing prevents the tongue from resting in the palate with the consequence of compromised facial growth. The face will grow more vertically and narrower when there is chronic mouth breathing.
- The constriction of the airway resulting from enlarged tonsils and adenoids can also contribute to sleep disordered breathing in children.
- The removal of enlarged tonsils and adenoids has been shown to improve sleep disordered breathing in children in the short term. If the myofunctional disorder and the mouth breathing are not corrected, the sleep disordered breathing in most cases will return a few years later.
- Sometimes enlarged tonsils and adenoids are the cause of mouth breathing and sometimes mouth breathing is the cause of enlarged tonsils and adenoids.
- Human physiology is based on breathing through the nose except in peak physical exertion.
- When breathing through the nose, the air is warmed, filtered, humidified, and partially disinfected by nitric oxide before it passes the adenoids, the tonsils, through the throat and into lungs.
- This well conditioned air in the lungs is ideal for the exchange of oxygen from the lungs to the blood.
- When mouth breathing, the cold, contaminated, and dry air flows directly over the tonsils, through the throat and into the lungs.
- This is hard on the sensitive tissues in the throat and lungs, compromises the effectiveness of oxygen exchange, and increases the risks of respiratory infections.
- The tonsils are part of the lymphatic system that is responsible for removing contaminants from the body but it can be overwhelmed by mouth breathing.
- In some cases, simply by changing breathing from mouth breathing to nasal breathing, enlarged tonsils and adenoids heal and shrink.
- In cases where the tonsils and adenoids remain enlarged even though nasal breathing has been established or in cases where nasal breathing cannot be established, the removal of the tonsils and adenoids should be considered.
- Referral to an Otolaryngologist (ENT) can take up to a year and often there will be guidelines in place whereby the removal of tonsils and adenoids will not be considered unless the child has had acute tonsillitis or strep throat multiple times (sometimes as
many as seven times).
- Some ENTs are more open to considering the removal of tonsils and adenoids in light of the effects on sleep disorders and poor facial growth.
There are many sleep-related questionnaires available for parents to take. One place to start is with the SDIS (Sleep Disorder Inventory for Students) questionnaire. Get it here
My Orofacial Myofunctional Therapy programs include:
1. Habit elimination therapy.
2. Exercises to improve nasal breathing and oral facial functions.
3. Teaching and promoting proper chewing, breathing, and swallowing.
4. Re-patterning head and neck posture problems.
5. Generalization and habituation of the new muscle patterns.
6. Emotional balancing
Parental involvement is very important to a child's success, and key to that success is a supportive environment that provides consistent encouragement and motivation necessary for positive and permanent change.