Palpability
Normally the almonds cannot be palpated from the outside. However, in the case of inflammatory changes, they may swell considerably and then be palpable from the outside. For inexperienced people, however, they can easily be confused with swollen lymph nodes, which are palpable at the same place, especially in the case of inflammation in the neck area. The tonsils are much easier to palpate from the inside in an inflamed state.Especially with the tongue, affected persons can easily palpate the enlarged organs. The doctor can also palpate the tonsils well from the inside with a spatula.
Pain
If pain occurs in the area of the tonsils, this is usually due to tonsillitis, which is very common in Germany. The type of pain varies depending on the severity of the disease and personal disposition. In most cases, sore throat, difficulty swallowing, pressure pain and temperature sensitivity occur.
Typically, the pain also radiates into the ears. In children who are not yet able to communicate well, ear pain can be an indication of a disease of the tonsils. In some cases, headaches are also associated with tonsillitis. If this type of pain, which is usually severe, is observed, a doctor should be consulted who may confirm or exclude the diagnosis of tonsillitis.
Tonsillitis
When colloquially speaking of “the almonds“, the palatine tonsils (Tonsillae palatinae) are usually meant. Here bacteria often settle, which then lead to an inflammation of the tonsils. This is known as tonsillitis or colloquially as “angina“.
The bacteria that most often lead to such an inflammation are beta-hemolytic group A streptococci (main representative Streptococcus pyogenes). Rarer pathogens are: Especially children and adolescents are more frequently affected by such tonsillitis. Patients feel a distinct pain when swallowing and often have a significantly reduced general condition with fever.
Diagnostically, a look into the mouth is particularly important. At the beginning of the disease, the tonsils are initially severely reddened, and later the characteristic white “pustule” can be seen. Antibiotics are often used for treatment, especially penicillin.
Painkillers and gargling with a disinfectant solution also provide relief. Tonsillitis usually heals within days to a few weeks. However, complications can also arise.
For example, the inflammation can also spread to the heart (endocarditis), kidney (glomerulonephritis) or joints (arthritis), or an abscess can develop in the area of the tonsils (peritonsillar abscess). The differential diagnosis of angina must exclude causes such as Pfeiffer’s glandular fever (mononucleosis), diphtheria or scarlet fever. In the case of frequently recurring tonsillitis (recurrent or chronic tonsillitis), especially in children, removal of the palatal tonsils (tonsillectomy) may be a possible treatment option.
- Pneumococci
- Haemophilus influenzae and
- Staphylococci
Polyps are colloquially called enlargements (hyperplasia) of the pharyngeal tonsil (Tonsilla pharyngealis). In technical jargon, these are called adenoids or adenoidal vegetation. They can become so large – especially in children – that they impede nasal breathing.
The affected children then breathe primarily through the mouth. They also suffer more frequently from inflammation of the middle ear, as the adenoids can obstruct the connection between the nasopharynx and the middle ear (tuba auditivaEustachian tube-ear trumpet). Furthermore, the misplacement of the tuba auditiva can lead to hearing loss, which in the worst case can result in delayed speech development in children.
Heavily enlarged pharyngeal tonsils are reduced in size by means of an adenotomy. Rarely can the pharyngeal tonsil grow back so strongly that a further surgical reduction is necessary.
