Removal of adnoids and tonsils

  My 4.5 year daughter has had some problems with nasal infections, after treating with antibiotics with not big improvement, the doctor suggested that she might need to have her adnoids removed.
  But he also suggested she should have her tonsils removed at the same time, kind of kill both birds with one stone.  I do wonder whether this is necessary.  Her tonsils are enlarged but I don't want to take them out if that's not absolutely necessary to improve her condition.
  Please let me know what you think.  She's booked for the procedure in October but the tonsils part makes me really uncomfortable.

Dear Agnes :
Thank you for your question .
1.  Recurrent throat infections and chronic tonsillitis are accepted as an indication for tonsillectomy , adenoidectomy or both . It's just difficult to decide what means recurrent throat infections , there is still a debate on how many infections warrant the need for surgery.
2.  adenoidectomy alone has had an impact on decreasing the incidence of recurrent ear infections and in persistence of fluid in the ears following an acute infection ( although ear tubes are better for treating effusions ) . Adenoidectomy may also help in cases of chronic adenoiditis ( infection and inflammation of the adenoids (adenoids) ) which may mimic sinusitis in it's presentation . Therefore an adenoidectomy is warranted before proceeding to sinus surgery , as it may relieve the symptoms .
3.  Tonsillectomy alone maybe helpful in a tonsillar abscess .
4.  Adenotonsillectomy has shown benefit in people with large enough tonsils and adenoids (adenoids) to cause obstructive sleep apnea with subsequent right heart failure . It has been documented to being helpful in reversing failure to thrive in the presence of large T&As . Other indications include dental occlusions , orofacial deformities and Halitosis ( bad mouth odor).
The only absolute indication for tonsillectomy is a high suspicion of malignancy in the tonsils , all other causes are relative ( which means they may or may not help). I hope that helps you decide on what you would like to do for your daughter . Keep us posted .
Thank you
L.M.
Disclaimer :This information is presented for educational purposes only .
Keywords : tonsilloadenoidectomy* (ENT)

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A related discussion, adenoids (adenoids) was started.