Tonsillectomy and Adenoidectomy | In Depth
What are tonsillitis and adenoiditis?
Adenoiditis happens when adenoids become inflamed from infection.
The symptoms of tonsillitis vary greatly depending on the cause of the infection, and can occur either suddenly or gradually. The following are the most common symptoms of tonsillitis. However, each child may experience symptoms differently. Symptoms may include:
- sore throat
- fever (either low-grade or high-grade)
- headache
- decrease in appetite
- not feeling well
- nausea and vomiting
- stomach aches
- painful swallowing
- visual redness or drainage in the throat
The symptoms of tonsillitis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.
The symptoms of adenoiditis vary greatly depending on the cause of the infection, and can occur either suddenly or gradually. The following are the most common symptoms of adenoiditis. However, each child may experience symptoms differently. Symptoms may include:
- breathing through the mouth
- noisy breathing
- snoring
- nasal speech
- periods at night when breathing stops for a few seconds
The symptoms of adenoiditis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.
Some children may be referred to an ear, nose, and throat surgeon to have the tonsils and adenoids removed. This surgery is called a tonsillectomy and adenoidectomy (T&A). Often, the tonsils and adenoids are removed at the same time, but, sometimes, only one is removed. Your child's physician will discuss this with you.
Tonsillectomy and Adenoidectomy | Tests & Diagnostics
What are the reasons to have a tonsillectomy and adenoidectomy?
The reasons for this surgery are not well defined, and physicians may differ in their views. The following are some of the more widely accepted reasons for having a T&A:
- sleep apnea, or periods at night when your child stops breathing
- trouble swallowing
- tumor in the throat or nasal passage
- bleeding from the tonsils that cannot be stopped
- significant blockage of the nasal passage and uncomfortable breathing
The following are T&A Guidelines from the American Academy of Otolaryngology:
- seven sore throats in one year
- five sore throats in each of two years
- three sore throats in each of three years
The sore throats may be associated with the following:
- fever above 101°F (Fahrenheit)
- discharge on the tonsils
- positive strep throat culture
Here are some additional reasons for removing the adenoids and tonsils that are more controversial:
- bad snoring
- recurrent infections or abscesses in the throat
- recurrent ear infections
- hearing loss
- chronic sinusitis, or infection in the sinuses
- constant mouth breathing
- frequent colds
- cough
- bad breath
What happens during tonsillectomy and adenoidectomy?
Tonsillectomy and adenoidectomy (T&A) surgery is a common major surgery performed on children in the United States. About 400,000 surgeries are performed each year. The need for a T&A will be determined by your child's ear, nose, and throat surgeon and discussed with you. Most T&A surgeries are done on an outpatient basis. This means that your child will have surgery and then go home the same day.
During the surgery, your child will be anesthetized in the operating room. The surgeon will remove your child's tonsils and adenoids through the mouth. There will be no cut on the skin.
In most cases, after the surgery your child will go to a recovery room where he/she can be monitored closely. After your child is fully awake and doing well, the recovery room nurse will bring your child back to the day surgery area.
At this point, if everything is going well, you and your child will be able to go home. If your child is going to stay the night in the hospital, your child will be brought from the recovery room to his/her room. Typically you would already be in the room to meet your child.
Bleeding is a complication of this surgery and should be addressed immediately by the surgeon. If the bleeding is severe, your child may return to the operating room.
Tonsillectomy and Adenoidectomy | Treatments & Care
How do I care for my child after a tonsillectomy and adenoidectomy?
We recommend the following:
- increased fluid intake
- pain medication, as prescribed
- no heavy or rough play for a duration of time recommended by the surgeon
What are the risks of having a tonsillectomy and adenoidectomy?
Any type of surgery poses a risk to a child. About 5 percent of children begin bleeding from the surgery site about five to eight days after the surgery and may require additional blood and/or surgery. Some children may have a change in the sound of their speech due to the surgery. The following are some of the other complications that may occur:
- bleeding (may happen during surgery, immediately after surgery, or at home)
- dehydration (due to decreased fluid intake; if severe, fluids through an intravenous, or IV, catheter in the hospital may be necessary)
- fever
- difficulty breathing (swelling of the area around the surgery; may be life threatening if not treated immediately)