Tonsils and adenoids are part of the body’s immune system. They’re located in the back of the throat and nose, and they help fight infection. Unfortunately for some children, when tonsils and adenoids are enlarged, they can cause more trouble than good and should be removed.
“Our bodies have many layers of defense, so if a child needs their tonsils and adenoids removed, the body will function perfectly fine without them,” says Warren Kraus, MD, an ear, nose, and throat physician at Atlantic Health System.
The need for surgery
If tonsils or adenoids are causing persistent problems, your pediatrician may recommend having them removed. The surgery is called a tonsillectomy and is often done with an adenoidectomy, to remove both tonsils and adenoids. An ear, nose, and throat doctor (ENT) performs the procedure on children for two reasons:
- Sleep Disruption - When tonsils are enlarged, they can block a child’s airway. This can cause restless sleep, snoring, or even sleep apnea, which involves occasional pauses in breathing that can lead to daytime fatigue and behavior issues.
- Recurring Infection – Repeated strep throats can require excessive antibiotic use. If a child has seven infections in a year or five infections a year for two consecutive years, removal is recommended.
Diagnosing the issues
“If a child is having trouble sleeping, we may recommend a sleep study to objectively measure the severity of a child’s sleep apnea,” says Dr. Kraus. “If your child is having recurring throat infections and is sick all the time, talk to your pediatrician or see an ENT. We may perform an exam using a small scope with a fiberoptic light in the nasal cavity to assess the size and condition of the adenoids.”
The risks of surgery
Tonsillectomy and adenoidectomy can have a few risks including bleeding, dehydration, infection, voice changes, or complications from anesthesia—but all of these are rare. Your doctor will monitor any issues and may recommend waiting to see if they go away on their own. In most cases, they do.
What to expect from surgery
The results of a sleep study and exam will determine whether your child can undergo a same-day surgery or stay overnight in the hospital. The procedure takes about 45 minutes under general anesthesia. Everything is done through the mouth with no external incisions.
“When kids wake up, their throat is sore for one or two weeks,” says Dr. Kraus. “It's important that they drink plenty of fluids. If kids get dehydrated, they can wind up back in the hospital.”
He explains that if your child is urinating three times a day, they’re probably getting enough liquids. They can slowly add soft foods, then solid foods. Most kids can return to school in about one week, but they should take it easy for two weeks with no rough play.
Effective outcomes
“Removing tonsils is a very effective procedure and usually cures most obstructive symptoms,” says Dr. Kraus. “For kids with sleep issues, there’s no more snoring and they wake up well rested. For kids with recurring infections, they no longer need frequent antibiotics. It’s life-changing.”
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