Tonsillectomy—Child

Definition

A tonsillectomy is the surgical removal of the tonsils. Tonsils are nodes found in the back of the throat.

The Tonsils

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Reasons for Procedure    TOP

Tonsils are part of the immune system. They trap germs that come in through your mouth and nose to prevent infection in the throat or lungs. Sometimes this can cause problems such as:

  • Chronic or recurrent bacterial throat infections that don’t respond to other treatment
  • Peritonsillar abscess-pocket of infection spreading outside the tonsil

Removing the tonsils may decrease the number of throat infections without affecting overall immune system

Some tonsils can become enlarged and cause an obstruction in the throat. The obstruction can lead to complications such as sleep apnea.

Possible Complications     TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Bleeding
  • Temporary breathing problems
  • Burns (if a hot knife or laser is used)
  • Nausea and vomiting
  • Infection
  • Dehydration
  • Injury to teeth, voice box, or soft palate

Factors such as weight or chronic disease may increase your child’s risk of complications. Teens who engage in tobacco, alcohol, and/or drug use may also increase their risk of complications.

What to Expect    TOP

Prior to Procedure

Your child’s doctor may do the following before the tonsillectomy:

  • Physical exam
  • Review your medical history
  • Blood and urine tests
  • Throat cultures
  • Sleep study—polysomnography

Talk to your child’s doctor about all medications your child uses. Your child may need to stop taking some medications prior to the procedure.

Anesthesia

General anesthesia will be used. Your child will be asleep during the procedure.

Description of the Procedure     TOP

The procedure is done through the mouth. Once your child is asleep, the doctor will grasp each tonsil with a special tool. The tonsils will then be cut away from the surrounding tissues and removed. The tonsils may be cut out with a scalpel, hot knife, or laser. A hot knife or laser will help seal the incision as the cut is made. An electrical current or clamps and ties will be used to stop bleeding at the site.

Tonsil Removal

Grasping a Tonsil
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How Long Will It Take?     TOP

About 20-45 minutes

How Much Will It Hurt?     TOP

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications and soft foods.

Average Hospital Stay     TOP

In most cases, your child can go home the same day. Other times, an overnight stay may be necessary to make sure your child is recovering as expected.

Post-procedure Care     TOP

At the Hospital

Right after the procedure, your child will be in a recovery room where their blood pressure, pulse, and breathing will be monitored. Recovery may also include pain or anti-nausea medications.

During your child’s stay, the hospital staff will take steps to reduce their chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your child’s incisions covered

There are also steps you can take to reduce your child’s chances of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your child’s healthcare providers to wear gloves or masks
  • Not allowing others not caring for your child to touch your child’s incisions

At Home

Home care will focus on controlling pain and nausea with medications and soft foods and soothing or cold fluids. It may take a couple days before return to normal activities. Throat, ear, or jaw pain may last for up to a week.

Call Your Doctor     TOP

After you leave the hospital, contact your child’s doctor if any of the following occur:

  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the site where the tonsils were removed
  • Signs of infection, including fever and chills
  • Pain, nausea, or vomiting that cannot be controlled with the medications they were given
  • Spitting or vomiting blood
  • New or worsening symptoms

Call for emergency medical services right away if your child is bleeding excessively or has difficulty breathing.

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Pediatric Surgical Association
http://www.pediatricsurgerymd.org
The Society of Thoracic Surgeons
http://www.sts.org/patients

CANADIAN RESOURCES:

Caring for Kids—Canadian Paediatric Society
http://www.caringforkids.cps.ca
The College of Family Physicians of Canada
http://www.cfpc.ca

References:

Baugh RF, Archer SM, et al. Clinical practice guideline: Tonsillectomy in children. Otolaryngol Head Neck Surg. 2011;144(1 Suppl):S1-S30.
Isaacson G. Tonsillectomy care for the pediatrician. Pediatrics. 2012;130(2):324-334.
Tonsillectomy. Cincinnati Children’s Hospital website. Available at:
...(Click grey area to select URL)
Updated July 2014. Accessed November 12, 2015.

Tonsillectomy. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated October 30, 2015. Accessed November 12, 2015.
Tonsils and tonsillectomy. Nemours Kids Health website. Available at:
...(Click grey area to select URL)
Updated May 2013. Accessed November 12, 2015.
Last reviewed November 2015 by Michael Woods, MD

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