Tonsillectomy—Child

Tonsillectomy—Child

Definition

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

The Tonsils

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Reasons for Procedure

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 do not respond to other treatment
  • Peritonsillar abscess—pocket of infection spreading outside the tonsil

Removing the tonsils may decrease the number of throat infections.

Some tonsils can also become enlarged. It may cause obstruct the flow of air. One example is sleep apnea.

Possible Complications

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

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

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.

How Long Will It Take?

About 20-45 minutes

How Much Will It Hurt?

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

Average Hospital Stay

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

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 Child's Doctor

Call your child's doctor if any of these 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 unexpected symptoms

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

If you think your child has an emergency, call for emergency medical services right away.

RESOURCES:

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

CANADIAN RESOURCES:

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

References:

Ingram DG, Friedman NR. Toward Adenotonsillectomy in Children: A Review for the General Pediatrician. JAMA Pediatr. 2015 Dec;169(12):1155-61.
Tonsillectomy. Cincinnati Children’s website. Available at: https://www.cincinnatichildrens.org/health/t/tonsillectomy. Updated January 2017. Accessed January 11, 2019.
Tonsillectomy. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114262/Tonsillectomy . Updated June 21, 2018. Accessed January 11, 2019.
Tonsils and tonsillectomies. Kids Health—Nemours Foundation website. Available at:
...(Click grey area to select URL)
Updated May 2013. Accessed January 11, 2019.
Last reviewed November 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 1/8/2019

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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