I am 15 years old, and I had my tonsils and adenoids removed at age 13. I had sleep apnea. Just recently, I have had a lot of mucus in the back of my throat, which makes me want to swallow constantly. I started snoring again (I snored before the removal of my adenoids, but NOT after), I have a hard time breathing out my nose, and my voice is starting to get nasally again -- just like it was before I had everything removed. My biology teacher told me it is possible that they could grew back. What do you think? If you do think that they grew back, should I get them taken out again?

Jenna

Tonsils and adenoids are examples of lymphoid tissue. This is the same tissue that forms large lumps in your neck whenever you have a bad sore throat. (Those lumps are lymph nodes.) Lymph nodes can grow and grow and grow ... sometimes to enormous size. Tonsils and adenoids have this same ability; as with lymph nodes, the individual cells that make up a tonsil or an adenoid have an enormous proliferative capacity.

Some body tissues can regenerate (grow back), and some cannot. Skin, for example, has an amazing ability to regenerate. The liver can also regenerate itself, provided it is not too severely injured. Nerves outside the central nervous system can regenerate to some degree, but nerves within the central nervous system (brain and spinal cord) have a very poor ability to regenerate.

If even a small bud of tonsil or adenoid tissue is left behind by the surgeon, the tonsil or adenoid may regrow. With regard to tonsillectomy, the risk of regrowth depends greatly on technique. At one time, some surgeons performed subcapsular tonsillectomies, in which the outermost shell of the tonsil was left behind. I am told this operation was less painful than a regular tonsillectomy, in which the entire tonsil is removed. Unfortunately, incompletely removed tonsils have a nasty tendency to regenerate.

With current surgical methods, adenoid regrowth is more common than tonsil regrowth. Adenoids are located above and behind the soft palate, in the nasopharynx. Without the use of special scopes, this area can be inspected only with a hand-held mirror. When the adenoids are removed, there is often a great deal of bleeding. Thus, the surgeon's ability to inspect the operative field (after the first big lump of adenoid tissue is removed) is hampered. Even the best ENTs (ear, nose and throat doctors) will, at times, leave behind a bit of adenoid tissue.

When tonsils or adenoids grow back, do they need to be removed? This decision should be approached in exactly the same manner as if a tonsillectomy or adenoidectomy had never been performed. For example, if regrown adenoids are causing your nasal obstruction, altered voice and snoring, then adenoidectomy is certainly an option worth discussing with your parents and doctors.

In my opinion, each case should be decided on its individual merits. Your history of previous adenoidectomy or tonsillectomy has relatively little bearing on a discussion of the pros and cons of reoperation.