Our Summary

Tonsillectomy, or the removal of tonsils, is a common surgery for children in Australasia. This paper discusses why the surgery is performed, how it’s done, and the risks associated with it, for those who aren’t doctors. The main reasons for doing a tonsillectomy are sleep apnea (trouble breathing during sleep) and repeated tonsillitis (inflammation and infection of the tonsils). Research shows that tonsillectomy can significantly improve sleep apnea, quality of life, and a child’s behavior. The surgery’s effects on a child’s cognitive abilities, however, are not as clear. For repeated tonsillitis, tonsillectomy can somewhat reduce the recurrence of sore throats.

The surgery generally involves removing the entire tonsil. However, a version of the surgery that only removes part of the tonsil can be used for sleep apnea and might have fewer risks. Children under 3 years old and those with more severe sleep apnea or other health conditions should be observed overnight after surgery. Most patients only need basic pain relief after surgery. Codeine, a strong pain medication, is not recommended due to reports of post-surgery deaths caused by breathing problems.

Overall, tonsillectomy is generally safe, with pain and bleeding after surgery (2-4% of cases) being the most common issues. Bleeding can be dangerous, but the rate of death is extremely low (about 1 in 30,000 cases).

FAQs

  1. What are the main reasons for performing a tonsillectomy?
  2. What are the common risks associated with tonsillectomy?
  3. Is a tonsillectomy a generally safe procedure for children?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tonsillectomy is to follow post-operative care instructions carefully to ensure proper healing and reduce the risk of complications. This may include taking pain medication as prescribed, staying hydrated, avoiding strenuous activities, and eating soft foods. It’s also important to contact your healthcare provider if you experience excessive pain, bleeding, or any other concerning symptoms after the surgery.

Suitable For

Patients who are typically recommended for tonsillectomy include:

  1. Children with sleep apnea: Tonsillectomy is commonly recommended for children with sleep apnea, as removing the tonsils can significantly improve breathing during sleep and overall quality of life.

  2. Patients with repeated tonsillitis: Individuals who experience frequent episodes of tonsillitis, characterized by inflammation and infection of the tonsils, may be recommended for tonsillectomy to reduce the recurrence of sore throats.

  3. Patients with severe symptoms: Those with severe symptoms of sleep apnea or repeated tonsillitis may be good candidates for tonsillectomy to alleviate their symptoms and improve their overall health.

  4. Patients who have not responded to other treatments: If other treatments for sleep apnea or tonsillitis have been unsuccessful, a tonsillectomy may be recommended as a last resort to provide relief.

  5. Children over 3 years old: Tonsillectomy is generally considered safe for children over 3 years old, as they are better able to tolerate the surgery and its potential risks.

It is important for patients to discuss their individual symptoms and medical history with a healthcare provider to determine if a tonsillectomy is the most appropriate treatment option for their condition.

Timeline

Before the tonsillectomy:

  • The patient may have been experiencing symptoms such as recurring tonsillitis or sleep apnea.
  • The patient and their caregivers would have consulted with a doctor to discuss the need for a tonsillectomy.
  • Pre-operative tests and evaluations may have been conducted to assess the patient’s overall health and suitability for surgery.

After the tonsillectomy:

  • The patient would have undergone the surgery, which typically involves the removal of the entire tonsil.
  • Post-operative care would include pain management and monitoring for bleeding or other complications.
  • The patient may experience some pain and discomfort for a few days following the surgery.
  • Over time, the patient should experience improvement in symptoms related to tonsillitis or sleep apnea.
  • Follow-up appointments with the doctor may be scheduled to monitor the patient’s recovery and evaluate the effectiveness of the surgery.

What to Ask Your Doctor

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

  1. Why do I need a tonsillectomy? What are the potential benefits for me?
  2. What is involved in the surgery process? Will I need to stay in the hospital overnight?
  3. What are the potential risks and complications associated with the surgery?
  4. What are the alternatives to tonsillectomy? Are there any non-surgical options that I could consider?
  5. How long is the recovery period after surgery? What can I expect in terms of pain and discomfort?
  6. Are there any specific post-operative instructions or restrictions that I should follow?
  7. How soon after the surgery can I expect to see improvements in my condition?
  8. Will I need any follow-up appointments or tests after the surgery?
  9. Are there any long-term effects or considerations I should be aware of after having a tonsillectomy?
  10. Are there any specific factors in my medical history or current health status that could affect the success of the surgery or my recovery?

Reference

Authors: Greig SR. Journal: J Paediatr Child Health. 2017 Nov;53(11):1065-1070. doi: 10.1111/jpc.13745. PMID: 29148201