Tonsils and Tonsillectomies

Tonsils and Tonsillitis

Tonsils are clumps of tissue on both sides of the throat that help fight infections.

Tonsils may swell when they become infected (tonsillitis). 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 can include:

• sore throat
• pain or discomfort when swallowing
• fever
• swollen glands (lymph nodes) in the neck

Enlarged tonsils without any symptoms are common among kids. Left alone, enlarged tonsils may eventually shrink on their own over the course of several years.

Don't rely on your own guesses, though — it can be hard to judge whether 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

Doctors might recommend surgical removal of the tonsils, called a tonsillectomy, for a child who has one or more of the following:

• persistent or recurrent tonsillitis or strep infections
• swollen tonsils that make it hard to breathe, particularly during sleep
• difficulty eating meat or chewy foods
• sleep difficulty that might be affecting the child's daily activities
• snoring and obstructive sleep apnea (when someone stops 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 kids and parents. 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.
• The operation will take about 20 to 30 minutes.
• The surgeon can get to the tonsils through your child's open mouth — there's no need to cut through skin.

Your child will wake up in the recovery area. Expect to spend about 5 hours or a bit longer at the hospital. Most kids go home on the same day, though some may require observation overnight. In general, kids under 3 years old and those with chronic disease will usually stay overnight for observation.

Rarely, children may show signs of bleeding, which would require a return to the operating room.

Depending on the surgical technique, the typical recuperation after a tonsillectomy may take several days to a week or more. Expect some 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 but 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: June 2010