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Throat Conditions

This page provides a useful list of some common ENT conditions that affect the throat and neck.


The tonsils are the two swellings at the back of the mouth which can be clearly seen when opening wide to say ‘aaah’. They are made of something called lymphoid tissue, which is the same thing as the appendix is made of.

What do the tonsils do?

Lymphoid tissue (the tonsils) is part of the immune system. However, tonsils can be removed without worry, as there are lots of other bits of lymphoid tissue in the body that can do their job. In fact, tonsils that are constantly infected lose their ability to contribute to the immune system anyhow.

Why do we remove tonsils?

A lot of work has been done over the years to make sure that tonsils are only removed if they really need to be.

1.Recurrent infection:

When infections in the tonsils are a problem (tonsillitis), a decision to remove the tonsils is made because the impact of these repeated infections (febrile painful illness, time off school, repeated courses of antibiotics etc) is thought to be worse than the undertaking of tonsillectomy (admission to hospital, anaesthetic etc).

2.Problems with breathing:

If the tonsils are very large, they can cause problems with children’s ability to breathe properly at night. Snoring is quite common, but there are some children who actually hold their breath repeatedly for short periods of time while asleep. This is called obstructive sleep apnoea. If sleep apnoea persists, it can have quite an impact on the way children function. They can be tired in the day, and their ability to concentrate can be affected. It can cause changes in behaviour and affect the ability of the child to grow properly. In rare cases, when the situation is very bad, there have been issues in which the way in which the heart and lungs work.

3. Other reasons:

There are other reasons for which we remove tonsils, including abnormal growth in them. These are very rare though and will be discussed with you by your doctor, if necessary.

For information and advice relating to the Tonsillectomy surgical procedure and post operative care click here

2. Lumps in the Neck

Enlarged lymph nodes are the most likely reason for lumps appearing in a child’s neck. Lymph nodes are tiny swellings which are present all over the body and are part of the immune system. When there is an infection the lymph nodes in the area close to the site of the infection swell up as the body acts to fight it. At this stage the nodes can be quite tender to touch. When the child gets better the lymph nodes shrink back down in size but often do not disappear completely.

Both bacterial and viral upper respiratory tract infections can cause lymph nodes in the neck to enlarge. Bacterial infections with nodes that are very tender and where the skin in the neck becomes red may need treatment with antibiotics. Rarely an abscess can form in a node which might need to be drained.

Lymph nodes can also swell up if there has been an insect bite close to them or if there is a patch of inflamed eczema.

Glandular Fever

This is caused by a virus (Epstein Barr) which is commonly transmitted in saliva. This is why it has been called the ‘kissing disease’ and is often seen in teenagers. Symptoms are a sore throat, a temperature and large lymph nodes in the neck. Those affected are often very tired and it can take a number of weeks for them to recover. Blood tests are used to diagnose the problem.

Other causes

There are other more unusual causes of neck lumps. If the swelling appears unrelated to infection or if it seems to be growing in size it should be checked. A useful investigation for neck lumps is an ultrasound scan. Sometimes a neck lump will need to be removed to be sure of what it is. This would involve a short procedure under general anaesthetic.

3. Voice Problems

It is very common for a child to lose their voice or for it to go a little husky for a few days when they have a cold. However, if the problem persists or did not seem to be related to infection further investigation may be needed.


There is a very simple and safe way of examining a child’s voice box (larynx) in the outpatients room by using a specially designed endoscope (telescope). This is passed into the nostril and only requires a little spray of local anaesthetic first. Children do need to be about 4 or 5 years old to be able to cooperate happily but it is sometimes possible to carry out the procedure on younger ones. Please do call my secretary to discuss this further.

Causes of Voice Problems

a) Vocal cord nodules

These are the most common cause of a persistent change in a child’s voice. They are firm swellings which appear on the vocal cords usually because of talking too much or shouting. Once diagnosed the vast majority settle with a course of specific speech and language therapy.

b) Vocal cord Polyps/Cysts

These swellings on the vocal cords are less common than nodules and also are not serious. They may need to be taken off though which would require a small operation.

c) Papillomatosis

This is a very rare condition in which wart like growths appear on the vocal cords. They can be removed but that would require a short general anaesthetic.

d) Vocal Cord Palsy

This is another rare problem when one of the vocal cords does not move properly. There is usually a history of some sort of surgery beforehand which has affected the nerve that supplies the voice box.