Tonsilectomy in Children

About 400,000 children have their tonsils removed each year, according to the American Academy of Otolaryngology-Head and Neck Surgery. The academy says that while the tonsillectomy is still one of the most common childhood surgeries, the number of procedures has been declining since the 1970s. Most children today have tonsillectomies to eliminate airway obstructions, rather than for infected tonsils.

Tonsillectomy Guidelines

• The tonsils are a pair of fleshy glands at the back of the throat designed to stop germs from entering the body. Sometimes, though, the tonsils themselves become infected, a condition called tonsillitis. The AAO-HNS' guidelines recommend tonsillectomies for children who have chronic tonsillitis--three or more tonsil infections in a year that antibiotics cannot cure. Children with enlarged tonsils also are candidates for tonsillectomies, especially if the glands obstruct their airways or cause sleep disorders.

Surgery

• An otolaryngologist, or ear, nose and throat surgeon, will probably perform your child's tonsillectomy. The surgery is an outpatient procedure that takes 30 minutes to an hour and is done under general anesthesia. The most common method for removing tonsils is cold-knife dissection, or use of a scalpel. Other options include electrocautery, a type of surgery that burns the tonsils away, or carbon dioxide laser. The surgeon might also remove your child's adenoids, located above the tonsils under the nasal passages, at the same time.

Risks

• A tonsillectomy carries the same risks as any major surgery, including bleeding, infection and reaction to anesthesia. About 5 percent of children experience bleeding five to eight days after a tonsillectomy and may need blood or additional surgery (see comments). If you notice that your child is swallowing a lot, he could be suffering from excessive bleeding. Other risks include trouble breathing, dehydration, fever or damage to the soft palate or teeth from surgical tools. Your child might also have a sore throat or swollen or sore tongue.

Recovery

• Most children can leave the hospital or clinic about four hours after the surgery, once they are fully awake and show no signs of breathing difficulty. Full recovery takes one to two weeks. Plan on keeping your child home from school for a few days and limit her strenuous physical activity for at least two weeks. Make sure she drinks lots of fluids. Soft, cool and bland foods might be the best choices for a few days. Minimize your child's risk of infection by keeping her away from crowds and sick people.

Warning

• Make sure your child takes the entire course of antibiotics if your doctor prescribes them. Your doctor might also prescribe a pain medication. You can also give your child an acetaminophen product. Do not give your child ibuprofen, naproxen or aspirin because these pain medications can increase bleeding risk. Children should never take aspirin because it puts them at higher risk for a rare, potentially fatal condition called Reye's syndrome.

Statistics

• The AAO-HNS says that in the 1970s, 90 percent of children had tonsillectomies for repeated infections. As of 2009, that number had dropped to 20 percent. Most children now have tonsillectomies to remedy obstructions that cause sleep problems. The academy says the switch has occurred because doctors have changed how they treat tonsillitis and upper airway problems.