Tonsillectomy

Definition

Tonsillectomy is surgery to remove the tonsils. These glands are at the back of your throat. Often, tonsillectomy is done at the same time as adenoidectomy, surgery to remove the adenoid glands.

Description

Your child will be given general anesthesia before surgery. They will be asleep and pain free.

• The surgeon will insert a small tool into your child’s mouth to prop it open.
• The surgeon then cuts or burns away the tonsils. The doctor will control bleeding, and the cuts heal naturally without stitches.

Your child will stay in the recovery room after surgery until they are awake and can breathe easily, cough, and swallow. Most children go home several hours after this surgery.

Why the Procedure Is Performed

The tonsils help protect against infections. But children with large tonsils may have many sore throats and ear infections.

You and your child’s doctor may consider a tonsillectomy if:

• Your child has infections often (seven or more times in 1 year, or five or more times over 2 years).
• Your child misses a lot of school.
• Your child has trouble breathing.
• Your child has abscess or growth on their tonsils.

Risks

The risks for any anesthesia are:

• Reactions to medications
• Breathing problems

The risks for any surgery are:

• Bleeding
• Infection

Rarely, bleeding after surgery can go unnoticed and cause very bad problems. Swallowing a lot may be a sign of bleeding from the tonsils.

Another risk includes injury to the uvula (soft palate).

Before the Procedure

Your child’s doctor may ask your child to have:

• Blood tests (complete blood count, electrolytes, clotting factors)
• A physical exam and medical history

Always tell your child’s doctor or nurse:

• What drugs your child is taking
• Include any drugs, herbs, or vitamins you bought without a prescription

During the days before the surgery:

• Ten days before the surgery, your child may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), warfarin (Coumadin), and other drugs like these.
• Ask your child’s doctor which drugs your child should still take on the day of the surgery.

On the day of the surgery:

• Your child will usually be asked not to drink or eat anything for several hours before the surgery.
• Give your child any drugs your doctor told you to give your child with a small sip of water.
• Your child’s doctor or nurse will tell you when to arrive at the hospital.

After the Procedure

A tonsillectomy is usually done in the doctor’s office or a clinic. Your child will go home the same day as the surgery. Children rarely need to stay overnight in the hospital for observation.

Complete recovery takes about 1 to 2 weeks. During the first week, your child should avoid people who are sick. It will be easier for your child to become infected during this time.

Outlook (Prognosis)

After surgery, the number of throat infections is usually lower, but your child will still get some.

References

Wetmore RF. Tonsils and adenoids. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 380.