Tonsils and ultrasound

[lfran]

Does anyone know if an ultrasound of the neck will show if tonsils are enlarged and/or infected? I can't locate anything on google.

 

Thanks!

[JoyBop]

It might show up but that technique is not used clinically which is why you are not finding it anywhere online. In other words, if you asked if the image showed enlarged tonsils they might comment one way or another but it won't get you much more than a consult to an ENT or other doc of if it looks problematic. Any one can clearly see if to ails are enlarged by looking directly in the throat though. I hope that is helpful.

[lfran]

That's true, but so many parents here have commented that their ENTs didn't want to remove their kid's tonsils because they looked fine pre-op, but once they were out the ENT said they were much larger and/or more infected than they originally appeared.

 

I'm just wondering if there are any pre-op procedures, like ultrasound, or visualizing with a nasal camera, that would show size or degree of infection, etc. My DS wouldn't meet insurance's criteria for T&A, so I'd love to have a visualization test that would give more info prior to having such surgery.

[JoyBop]

We have been exploring the same options ourselves. My daughters tonsils are enormous and pitted but that doesn't qualify her by insurance to have a T&A. Our Ent ordered a sleep study to see if she had apnea. If I had said I witnessed her breathing stopped at night he would have proceeded with the procedure but I couldn't lie and really don't want the operation if there isn't a just cause. Insurance won't pay to remove enlarged tonsils unless it caused obstructed sleep apnea. Every insurance co is different but many insist that there be 5-7 positive strep cultures in a year, or sleep apnea. With that said, if an ENT opted to do the surgery electively for the sake of trying to prevent strep in a PANDAS pt then you could always pay out if pocket. Again, my DS tonsils are so large they are pushing up against each other and the ENT commented on how huge they were. But he and I both know that that alone isn't grounds for a T&A. These are all tough issues to navigate for sure.

[lfran]

Yes but I was wondering if ultrasound would show infection that the tonsils might be harboring.

[JoyBop]

No I do t believe it is possible to show an infection. You should ask the dr to document if be sees unusual or enlarged finding especially in the tonsils. Then request the doctors office notes from that visit. That way you have the documentation to pursue other specialists if that is an obstacle at this point. Otherwise a white blood cell count might help support an infection one way or another.

If you are certain there is an infection you could go back to your Ent or better yet, find a new one since you disagree with this one.