Tonsillectomy and Adenoidectomy

Your child may have been referred to an ear, nose, and throat surgeon (ENT) to have their tonsils and adenoids removed. This surgery is called a tonsillectomy and adenoidectomy. Often the tonsils and adenoids are removed at the same time. But sometimes only one or the other is removed. Your child’s ENT will discuss this with you.

The tonsils are tissue located on either side of the back of the throat. The adenoids are located behind the nose and at the top (roof) of the mouth. Both the tonsils and adenoids are part of the immune system, the part of the body that fights infection and disease.

Tonsillectomy

A tonsillectomy may be recommended if your child has throat infections that keep coming back. A throat infection means your child has a sore throat with fever, swollen neck glands, drainage from the tonsils or a positive strep test. Recurrent throat infections may include:

• 7 or more throat infections in 1 year
• 5 or more throat infections in each of 2 years
• 3 or more throat infections in each of 3 years.

A tonsillectomy may also be recommended if your child has recurrent throat infections and:

• Is unable to take antibiotics or is allergic to antibiotics
• Has episodes of fever, sores in the mouth, sore throat and swollen neck glands
• Has had an infected area near the tonsils.

A tonsillectomy may also be recommended if your child has:

• Abnormal breathing while sleeping with enlarged tonsils. This is found by a test called a polysomnography (PSG). This test is a sleep study that may confirm brief times when your child stops breathing while sleeping (sleep apnea)
• Very large tonsils that block breathing through the nose or cause trouble swallowing

Adenoidectomy

Adenoidectomy is recommended if your child has a lot of trouble breathing through the nose. It may also be recommended if your child has:

• A long-term (chronic) sinus infection
• Middle ear infections that keep coming back
• A chronic middle ear infection with fluid and already has ear tubes

All surgeries have risks, including bleeding, infection and complications from general anesthesia. The risks of tonsillectomy and adenoidectomy include:

• Long-term throat pain
• Excessive bleeding from the tonsils
• Damage to teeth, voice box, throat, or roof of the mouth, or other nearby tissue
• Breathing problems
• After surgery, your child may have nausea, vomiting, pain, dehydration, bad breath, ear pain or throat or lung problems

Your child’s doctor or ENT may want to do some tests before surgery. If your child has problems while sleeping, a sleep study may be done.

The ENT will explain the surgery and answer any questions. Make sure you talk with your child’s ENT about:

• Any medicines that your child should not take before surgery. This includes over-the-counter medicines
• When your child needs to stop eating and drinking. For example, it's common not to eat or drink after midnight the night before surgery
• When your child needs to arrive at the hospital or facility
• What to expect and how to care for your child after surgery
• When your child can get back to normal activities, including returning to daycare or school.

And if your child gets sick before surgery, call their ENT. Surgery may need to be rescheduled.

• After the surgery, your child will go to the postanesthesia care unit where they can be watched closely as they wake up from anesthesia
• Your child will get medicine for pain

Your child’s throat will be very painful for the first 2 days. Pain may last up to 2 weeks.

Directions for caring for your child at home may include:

• Making sure your child drinks plenty of fluids. This helps to prevent dehydration and helps to lessen pain. Avoid milk, orange, and other citrus juices
• Giving pain medicine. Your child’s ENT will tell you what to give your child. Call your child’s ENT if you are unable to control your child’s pain
• Giving your child soft foods to eat. Don't give them hard or spicy foods
• Letting your child be active while at home. They should stay away from heavy or rough play. Your child's ENT will tell you when your child can go back to all normal activities
• Staying away from others with colds or other respiratory infections
• Make sure you take your child to all follow-up appointments with the ENT. And call the ENT if your child is not getting better, or if you have any questions or concerns