Can Your Tonsils Cause Ear Problem?

Our tonsils hardly get any attention – until something goes wrong with them! Inflamed tonsils can cause throat pain and swelling, but can they also mean an ear infection because of the interconnected ear–nose–throat channel? Let’s find out.

What Are Tonsils?

We have two tonsils, one on either side of the back of the throat. This pair forms a part of the immune system and contains cells which can trap and kill bacteria and viruses circulating in the body. When the infection is within the tonsils itself, they become inflamed and red, with a coating of white spots. This condition, called tonsillitis, is fairly common in children though it can occur later on also. It is usually a self-limiting condition and improves on its own with minimal complications. Various viruses and bacteria – for example, the adenovirus, the Epstein-Barr virus, or the streptococcus bacteria (causing what is often known as strep throat) – can lead to tonsillitis.

The Signs

The earliest symptoms of tonsillitis are a sore throat and pain when swallowing. A throat examination will show swollen tonsils, a reddened throat,

and swollen lymph glands under the jaw and in the neck. These may be accompanied by fever, headache, loss of voice, and ear pain. Depending on the type of infection, there could be small blisters in the mouth and foul-smelling breath.

Getting Serious

As a common childhood ailment, tonsillitis is usually not very troublesome and lasts about a week. Of course, complications can arise.

  • A secondary infection may occur in the middle ear or sinuses.
  •  There may be a rash if it is due to a streptococcus infection.
  •  In rare cases it can lead to a throat abscess or diseases like rheumatic fever or a particular kidney disease can occur.

Ear Attack

The ear, nose, and throat passages are very clearly interconnected – as you would have realized when the bitter nose or ear drops landed in your throat also! Most of us, especially as kids, have had at least one middle ear infection accompanied by ear pain and a fever. You can thank the Eustachian tube for that. The passage between your middle ear and your throat, this tube keeps pressure from building up

by circulating air in and out of your middle ear. When you have an allergy attack, cold, sore throat, or tonsillitis, the Eustachian tubes can get blocked, allowing germs to get in the middle ear. This leads to an ear infection.1


For virus infections, treatment could be as simple as a round of paracetamol to bring down the fever. For tonsillitis caused by bacteria, antibiotics may be prescribed to cure the infection. Surgery to remove the tonsils (tonsillectomy) is not as common an occurrence now but typically necessary for those suffering from repeated, severe infections (say, as many as seven in a year) that impact normal life.2 The frequency of tonsillectomies has been found to

be high in preschool-aged children, declines thereafter, and increases again in teenage.3

While the frequency of tonsillectomy has been on the decline, as per one Australian study, surgical intervention for middle ear infections has been rising.4 Another study found ENT surgery rates had gone up by 21% during the study period. This was attributed to increased focus on child care in general and safer medical techniques and guidelines that helped to diagnose these conditions. While tonsillitis itself is leading to fewer surgical removals, the resultant ear infections may call for antibiotics, hospitalization, and invasive remedies. Surgery may be required if the infection has damaged the ear drum or surrounding

tissue or bone.5

Tonsil Stones

While inflammation of the tonsils or tonsillitis is more of a childhood occurrence, tonsil stones or tonsilloliths are actually quite common in adults. These are basically calcium deposits in the crevices and folds of the tonsils because of accumulated bacteria, dead cell, mucus, and debris. The most common symptoms are bad breath and a sore throat, with pain in the affected area. Given the ear–throat interconnectivity, persistent earache is also a troublesome possibility.6 The recommended treatment for tonsil stones is usually gargling and massaging of the tonsils to heal and reduce the odor. If the condition is severe, the tonsils might need to be removed. Of late, a less invasive laser treatment has also emerged.7

Tonsillitis can be a recurring problem for many kids and a challenge for parents. Later in life, tonsil stones are more likely to trouble you. Remember to look out for additional symptoms like ear pain so that the resultant ear infections can also be treated quickly.