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Tonsils and Tonsillectomies
Everybody's heard of tonsils. But not everyone knows what tonsils do or why they may need to be removed. Knowing the facts can help alleviate the fears of both parents and kids facing a tonsillectomy.
Tonsils and Tonsillitis
Tonsils are clumps of tissue on both sides of the throat that trap bacteria and viruses entering through the throat and produce antibodies to help fight infections.
Tonsillitis occurs when tonsils become infected and swell. If you look down your child's throat with a flashlight, the tonsils may be red and swollen or have a white or yellow coating on them. Other symptoms of tonsillitis may include:
- sore throat
- pain or discomfort when swallowing
- fever
- swollen glands (lymph nodes) in the neck
But enlarged or swollen tonsils are a common finding for many kids. Left alone, your child's enlarged tonsils may eventually shrink on their own over the course of several years. Don't rely on your own guesses, though — you might not be able to judge whether your child's tonsils are infected. If you suspect tonsillitis, contact your doctor. Recurrent sore throats and infections should also be evaluated by the doctor, who may order a throat culture to check for strep throat.
About Tonsillectomies
The surgical procedure to remove tonsils is called a tonsillectomy. The doctor may suggest tonsillectomy if your child has one or more of the following:
- persistent or recurrent tonsillitis or strep infections
- swollen tonsils that make it hard to breathe
- difficulty eating meat or chewy foods
- snoring that might be affecting the child's daily activities
- obstructive sleep apnea (a condition in which your child may stop breathing for a few seconds at a time during sleep because enlarged tonsils are partially blocking the airway)
Surgery, no matter how common or simple the procedure, is often frightening for both child and parent. You can help prepare your child for surgery by talking about what to expect. During the tonsillectomy:
- Your child will receive general anesthesia. This means the surgery will be performed in an operating room so that an anesthesiologist can monitor your child.
- Your child will be asleep for about 20 minutes.
- The surgeon can get to the tonsils through your child's open mouth — there's no need to cut through skin.
- The surgeon removes the tonsils with a series of incisions and then stops any bleeding.
Your child will wake up in the recovery area. In most cases, the total time in the hospital is 5 to 10 hours. However, kids who have trouble breathing or show signs of bleeding will return immediately to the operating room. And kids under 3 years of age and kids with chronic disease, such as seizure disorders or cerebral palsy, will usually stay overnight for observation.
The typical recuperation after a tonsillectomy often involves a week or more of pain and discomfort due to the exposure of the throat muscles after the tonsils are removed. This can affect your child's ability to eat and drink and return to normal activities.
Intracapsular tonsillectomy, a variation on traditional tonsillectomy techniques, is surgery in which all involved tonsil tissue is removed; however, a small layer of tonsil tissue is left in place to protect the underlying throat muscles. As a result, the recovery is much faster because most kids experience less pain, don't need as much strong pain medication, and are more willing to eat and drink. Additionally, the risk of bleeding after surgery is significantly less than with a traditional tonsillectomy. Since residual tonsil tissue remains, there is a very slight chance that it can re-enlarge or become infected and require more tonsil surgery, but this occurs in less than 1% of children undergoing intracapsular tonsillectomy.
Reviewed by: Steven P. Cook, MD
Date reviewed: April 2007
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