Our Summary

In the United States, tonsil and adenoid removal surgeries are some of the most common procedures carried out on children, with over 500,000 operations happening every year. These surgeries used to be done mainly for repeated tonsillitis, but now they’re typically done for issues related to blockages. When the surgeries are done for the right reasons, they can significantly improve a child’s health and quality of life. With these conditions and surgeries being so common, it’s important that healthcare providers for kids stay up-to-date with the latest research and recommendations. This paper gives a summary of when and why these surgeries should be done, what the risks and outcomes are, and briefly touches on the different ways they can be performed.

FAQs

  1. What are the most common reasons for tonsil and adenoid removal surgeries in the United States today?
  2. How can tonsil and adenoid removal surgeries improve a child’s health and quality of life?
  3. What are some of the risks and potential outcomes of tonsil and adenoid removal surgeries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tonsillectomy is to make sure to follow all pre-operative instructions provided by the healthcare team. This may include fasting before the surgery, avoiding certain medications, and making arrangements for transportation to and from the hospital or surgical center. Following these instructions can help ensure a successful surgery and smoother recovery process. Additionally, it’s important to discuss any concerns or questions with the healthcare provider before the surgery to fully understand the procedure and what to expect during the recovery period.

Suitable For

Patients who are typically recommended for a tonsillectomy include:

  1. Recurrent tonsillitis: Children who have multiple episodes of tonsillitis (usually more than seven episodes in a year, more than five episodes in two consecutive years, or more than three episodes in three consecutive years) may be recommended for a tonsillectomy.

  2. Obstructive sleep apnea: Children with obstructive sleep apnea, a condition in which the airway is partially or completely blocked during sleep, may benefit from a tonsillectomy to improve breathing and quality of sleep.

  3. Enlarged tonsils: Children with significantly enlarged tonsils that obstruct the airway, cause difficulty swallowing, or contribute to speech issues may be recommended for a tonsillectomy.

  4. Abscesses: Children who develop abscesses in the tonsils, which are painful collections of pus, may require a tonsillectomy to remove the infected tissue.

  5. Tonsil stones: Children who develop recurrent tonsil stones, which are hard, calcified formations that can cause bad breath and discomfort, may be recommended for a tonsillectomy.

It’s important for healthcare providers to carefully evaluate each patient’s individual situation and symptoms before recommending a tonsillectomy. The decision to proceed with surgery should be based on the specific needs and health of the child, as well as a thorough discussion of the risks and benefits with the child’s parents or guardians.

Timeline

Before the tonsillectomy:

  1. The patient may have a history of recurrent tonsillitis, sleep-disordered breathing, or other issues related to the tonsils and adenoids.
  2. The patient and their family may consult with an ear, nose, and throat (ENT) specialist to discuss the potential benefits and risks of the surgery.
  3. The ENT specialist may recommend a tonsillectomy if conservative treatments have not been effective in addressing the patient’s symptoms.
  4. Pre-operative tests and evaluations may be conducted to ensure the patient is healthy enough for surgery.

After the tonsillectomy:

  1. The patient will undergo the surgery, which typically takes about 30 minutes to an hour to complete.
  2. After the surgery, the patient will be monitored in the recovery room before being discharged home the same day.
  3. The patient may experience pain, sore throat, and difficulty swallowing in the days following the surgery.
  4. The patient will be provided with pain medication, instructions for care at home, and follow-up appointments with the ENT specialist.
  5. The patient will gradually recover over the next 1-2 weeks, with most returning to normal activities within 2 weeks.
  6. The patient should avoid strenuous activities, certain foods, and exposure to sick individuals during the recovery period.
  7. The patient and their family should contact the healthcare provider if there are any concerns or complications during the recovery process.

What to Ask Your Doctor

Some questions a patient should ask their doctor about tonsillectomy include:

  1. Why is a tonsillectomy recommended for me or my child?
  2. What are the potential risks and complications associated with the surgery?
  3. What is the expected recovery time and what can I do to help with the healing process?
  4. Are there any alternative treatments or options to consider before proceeding with a tonsillectomy?
  5. What is the success rate of this surgery for my specific condition?
  6. How many tonsillectomy procedures do you perform each year?
  7. What type of anesthesia will be used during the surgery?
  8. Will there be a need for any follow-up appointments or additional treatments after the surgery?
  9. Are there any specific dietary or activity restrictions that need to be followed after the surgery?
  10. How long will it take for me or my child to see improvements in symptoms after the surgery?

Reference

Authors: Nguyen BK, Quraishi HA. Journal: Pediatr Clin North Am. 2022 Apr;69(2):247-259. doi: 10.1016/j.pcl.2021.12.008. PMID: 35337537