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Tonsillectomy and Adenoidectomy

(Tonsils Removal, Adenoids Removal)

Procedure overview

A tonsillectomy is a surgical procedure to remove the tonsils. Tonsils are small, round glands in the back of the mouth, on the sides of the throat.

Often the adenoids are removed at the same time as tonsils. This procedure is known as an adenoidectomy. The adenoids are glands similar to the tonsils, but located above the soft roof of the mouth.

The tonsils and adenoids are thought to fight infections. But in many children, the glands themselves can become large and inflamed—a source of numerous infections and sick days. When this happens, your child’s doctor may feel that taking them out is better than fighting the illnesses that inflamed tonsils and adenoids can cause.

Reasons for the procedure

Medical conditions known as tonsillitis and adenoiditis are the primary reasons your child might need to have tonsils and adenoids removed. The typical symptoms of tonsillitis are a sore throat, fever, headaches, a decrease in appetite, painful swallowing, and redness of the throat. Symptoms of adenoiditis are noisy breathing or breathing through the mouth, snoring, nasal speech, or halted breathing at times during the night.

The decision to have surgery is often based on the frequency, intensity, and severity of your child’s symptoms. Your child’s doctor may consider a tonsillectomy and adenoidectomy when tonsillitis or adenoiditis causes the following situations:

  • Your child has frequent infections—at least seven episodes in the past year, or at least five episodes per year for two years, or at least three episodes per year for three years, according to national guidelines.

  • The infections result in a number of missed school days.

  • Your child has trouble breathing, either when awake or asleep.

  • Your child has trouble swallowing.

Risks of the procedure

Children usually have few side effects after a tonsillectomy and adenoidectomy. But there are risks involved with any surgical procedure, such as breathing problems and medication reactions related to anesthesia, though these are rare.

Other potential risks of a tonsillectomy and adenoidectomy include:

  • Bleeding during the surgery, immediately afterward, or at home

  • Dehydration from not drinking enough fluids

  • Difficulty breathing from swelling after the surgery

  • Infection at the site of the surgery

There may be other risks, depending on your child’s specific medical condition. Be sure to discuss any concerns with your child’s doctor before the procedure.

Before the procedure

  • Your child’s doctor will likely perform a number of blood tests, do a physical exam, and check your child’s medical history to make sure he or she is a good candidate for the surgery.

  • Tell your doctor about any drugs your child is taking, including over-the-counter medications and vitamins. Ask what drugs your child should and should not take leading up to the surgery.

  • About 10 days before the surgery, you may need to have your child stop taking aspirin, ibuprofen, naproxen, or other medications that increase the risk of bleeding. Aspirin should never be given to children or teenagers because of the risk for Reye's syndrome, a rare but potentially fatal disease. 

  • Several hours before the surgery, your child will need to stop eating and drinking.

During the procedure

Tonsillectomy and adenoidectomy are fairly common procedures. They are usually done on an outpatient basis. That means your child can have the surgery and go home on the same day. Some very small children, children with other existing medical problems, or children who experience surgical complications may be kept in the hospital overnight.  

In general, this is what will take place during a tonsillectomy and adenoidectomy:

  1. Your child will be taken to the operating room.

  2. Once there, anesthesia will be given to sedate him or her for the procedure, which typically lasts 30 to 45 minutes.

  3. The doctor will use surgical instruments to remove the tonsils and adenoids. With almost all tonsillectomies and adenoidectomies, the glands are removed through the child’s mouth. There are no cuts to the skin and no visible scars.

  4. Once the procedure is over, your child will be taken to a recovery room for close monitoring for the next few hours.

After the procedure

Once in the recovery room, a nurse will monitor your child’s progress. In most cases, you will be able to take your child home within a few hours. If your child is bleeding, has other complications, or is recovering slowly, he or she may need to spend the night in the hospital.

Full recovery from a tonsillectomy and adenoidectomy typically takes about one to two weeks. During that time, it’s important for your child to drink a lot of fluids, eat soothing and soft foods, such as ice cream and pudding, and avoid any rough playing. Your doctor will probably suggest pain medication to ease any discomfort during the first few days. Your child should also completely avoid anyone who is sick for at least the first week because it is easier to develop an infection during that time.