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Portrait of Dr. Sandra Ettema
Dr. Ettema with a patient

April 20, 2011

SIU Med School Specialist Offers Parents Advice on Tonsillitis

A sore throat is a common complaint of children.  If the pain is severe, it could be tonsillitis.  Nearly every child between the ages of five and fifteen experiences tonsillitis at least once says Dr. Sandra Ettema, assistant professor of otolaryngology at Southern Illinois University School of Medicine and a member of SIU HealthCare in Springfield. 

Tonsillitis is an infection of the lymphoid tissue in the back of the throat and can be very painful.  School age children are especially susceptible because they are around many other children and frequently exposed to the disease.

“The tonsils are lymph nodes in the back of the mouth and top of the throat.  They normally help filter out bacteria to prevent infection in the body.  When the tonsils become overwhelmed by a bacterial or viral infection, they swell and can become inflamed, causing tonsillitis,” says Ettema, who also is a member of the St. John’s Children’s Hospital staff.

Children experience a wide range of symptoms with tonsillitis.  The primary ones are a sore throat that lasts 48 hours or more, difficulty swallowing, ear pain, a runny nose and voice changes.  There may be jaw pain or a bump under the jaw when a lymph node is swollen as well as fever and chills.  Swollen, enlarged tonsils also can cause snoring and sleep apnea in children.

“Tonsillitis often goes away on its own after four to ten days.  If it does not go away, the child should see a physician who may do a strep test along with a throat culture to determine whether it is caused by streptococcus bacteria,” says Ettema.

Most tonsillitis is caused by group A streptococcus bacteria, which is treated with antibiotics.  Over-the-counter medications such as Tylenol or Motrin can be used to help decrease the fever and make the child feel a little better.  Adequate rest and fluid hydration are also very important.

“After a child has five to seven episodes of tonsillitis in a year and is missing school, we would consider surgery to remove the tonsils,” says Ettema. 
A tonsillectomy is one of the most common surgical procedures in children.  More than a half million procedures are performed annually in children under 15 years old in the U. S. but not just for tonsillitis.

Today many young children have their tonsils removed because of sleep disorder breathing.  They may snore or even stop breathing occasionally during their sleep.  Or they may have constant nasal congestion, behavior problems and even problems with wetting the bed.  These symptoms all could be due to enlarged tonsils and adenoids.

If surgery is needed for a child aged three years or younger, they are kept overnight in the hospital because it’s hard for them to understand that they need to drink lots of fluids.  While in the hospital, they are given fluids intravenously so they get the necessary fluid hydration.  With older children and adults, the surgery is done as an outpatient procedure. 

“The recommended recovery time for tonsillectomy is usually one week of rest at home.  The second week after surgery, patients can go back to school or work, but they need to stay quiet and not participate in any physical activity.  The throat area needs to heal to prevent bleeding which can cause serious problems and might require additional surgery,” explains Ettema.

The younger the patient is when they have the tonsillectomy, the faster their recovery.  Adults tend to have longer recovery times than children because adults have more blood vessels in the throat area. 

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Ettema joined the SIU faculty in 2008.  She completed a fellowship in laryngology at SIU (2008) and her residency in otolaryngology at the Medical College of Wisconsin (2007).  Ettema earned her medical, doctoral, master’s and bachelor’s degrees at the University of Illinois at Urbana-Champaign (2002, 1999, 1993, 1991).