Tonsillectomy (removal of tonsils) is recommended for people who experience frequent throat infections. Adenoidectomy (removal of adenoids) is recommended for recurrent ear or nasal infections. Other reasons to remove tonsils and adenoids is if they are enlarged, as this can cause obstructive symptoms, such as sleep apnea, swallowing difficulties, nasal sounding speech, dental malocclusion, and even heart failure. Recent reports also link enlarged tonsils and adenoids to obstructive breathing and sleep apnea, which can cause poor concentration and irritability during the day. This can be confused with ADHD. These patients often improve significantly after removal of their tonsils and adenoids.