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Tonsillectomy for Children

By Kelli Rudman, M.D.

Doctor checking childs tonsils

​​​​​​Tonsil removal surgery is called a tonsillectomy. The tonsils are the two round tissues that live in the back of the throat. They stop the germs that enter the body when we breathe from going past the throat. Though the tonsils are the first line of defense in the immune system, some patients may benefit from having the tissue removed from the throat completely.

Why Do People Have Tonsillectomies?

One common reason for removing the tonsils is to prevent future infections. Since the job of the tonsils is to stop bacteria and viruses from entering the body, the tissues are exposed to a large number of immune system threats. Sometimes the organs cannot keep up and a patient may develop chronic tonsil infections, or tonsillitis.

​Doctors may also recommend a tonsillectomy if a tonsillitis episode is not improving after antibiotic treatment.

​Research shows that the benefit outweighs the risk of a tonsillectomy if your child has tonsillitis:

  • Seven times or more in one year.
  • Five or more times a year for two consecutive years.
  • Three or more times a year for three consecutive years.

Another reason a tonsillectomy may be performed is to improve bodily functions that are hindered by enlarged tonsils. Oversized tonsil tissue can cause difficulty breathing, stops in breathing during sleep and difficulty swallowing.​

Less common reasons for removing the tonsils include cancer and recurrent tonsil bleeding.

Tonsillectomy Timeline

The tonsillectomy surgery is a short procedure. Patients are usually in surgery for less than an hour and able to go home the same day.

After surgery, patients will typically need 10 – 14 days to recover. During this time, the goal is to focus on pain management and rest. Tonsillectomy patients may experience the following after their procedure:

  • Discomfort: The first 24 hours are usually the most painful. The physician may prescribe a combination of IV medication and oral medication to help with the pain. It is important to take the pain medication on a scheduled basis for the first couple of days, to minimize pain. When patients have good pain control, they are more likely to drink and eat and thus heal faster.
  • Nausea: Occasionally patients will be nauseated following a tonsillectomy. Should this occur, the physician can prescribe a medication to help alleviate the symptoms.
  • Bleeding/Drainage: Occasionally there is a small amount of blood noted around the nostrils when returning from the recovery room. Should bleeding occur after discharge, be sure to contact the physician.

Tonsillectomy Recovery

As with all surgeries, it is important to increase fluid intake and time spent resting to achieve a healthy recovery. After your tonsil removal surgery:

  • No vigorous activity for 1-2 weeks or until after follow-up appointment.
  • Drink plenty of fluids. Water, soft drinks, juice, and popsicles are good choices.
  • Solid Foods may be reintroduced as patient resumes interest. Usually bland types of food are tolerated better than spicy, acidic foods.
  • Pain control medication will most​ likely be prescribed. It is important to take pain medication, especially if the patient is not drinking very well.
Your child may return to school when he or she is:
  • Following a normal sleep schedule.
  • Eating a normal diet.
  • Able to get through the day without pain medication.

When to See a Doctor After a Tonsillectomy

Follow-up appointments after tonsil removal are usually scheduled 1 – 2 weeks after discharge. Though kids generally do well after a tonsillectomy and it is a routine procedure, there are complications to be aware of.

Contact your physician if:

  • You notice fresh (bright red) blood in your child’s saliva
  • Your child develops a fever at 102 degrees Fahrenheit or higher
  • You notice that your child is showing signs of dehydration. These may include reduced urination, fatigue, dizziness or crying with no tears.
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