We’ve all been to the doctor where they check your vitals, heart, lungs and neck, among other things. But, what are they even checking in the mouth? It’s the tonsils! For kids, this is the part where they stick out their tongue and say “ahhh.” But, when their tonsils are causing problems, it may be time for a tonsillectomy.
What are tonsils?
Tonsils are glands in the throat (the little golf ball-looking things in the back). Their job is to help stop germs from getting us sick. Think of the tonsils as military bases where the soldiers – white blood cells – live to fight infection in our body. Sometimes, when germs and viruses get past the first lines of defense, an infection can happen, like strep throat or tonsilitis. And sometimes, after lots of sore throats or colds that all kids get, the tonsils can become enlarged and sometimes stay that way.
What is obstructive sleep apnea?
When we fall asleep, the muscles in our throat relax, just like the rest of our body. For most people that’s not a problem. But for some, it can cause snoring (vibration of the tissues of the throat) or even blockage that happens from time to time (“obstruction”) of the throat during sleep. These blockages are usually brief, but if they are frequent or happen a lot, they can lead to poor sleep quality. This can add to a variety of symptoms like fatigue, poor concentration, irritability, hyperactivity, or bed-wetting. In very severe cases, it can even cause strain on the heart and lungs.
Strep throat and tonsilitis are common tonsil infections and include symptoms like:
Red or swollen tonsils
Tender, or swollen neck glands
If your child is feeling any of these symptoms, it’s best to have a doctor help provide a diagnosis and medication, if needed.
What is a tonsillectomy?
Tonsillectomy is a surgery where the tonsils are taken out of the throat. Tonsillectomy can help reduce strep throat episodes, may help with snoring, obstructive breathing and help improve sleep. But there are some common misunderstandings about tonsillectomies:
Children of any age can have a tonsillectomy. Most people think children have their tonsils removed around the age of 12, but a tonsillectomy may be needed at any age.
Enlarged tonsils don’t always need to be removed. If your child isn’t having any problems or symptoms, they may not have to be removed. Your child’s doctor or an ENT specialist can help you figure out if a tonsillectomy is needed.
Strep throat used to be the main indicator for a tonsillectomy, but not so much anymore. Frequent episodes of strep throat was a very common reason to undergo a tonsillectomy in the past, but guidelines have since been updated. It turns out tonsillectomy doesn’t help in most cases unless the frequency of infections is really severe, because most kids will stop having frequent infections without surgery. Also, kids can still get strep throat infections even after the tonsils have been removed. Based on national guidelines, to be eligible for a tonsillectomy because of sore throats, a child must generally have had at least:
7 strep throat episodes in the last 12 months, or
5 strep throat episodes per year over 2 years straight, or
3 strep throat episodes per year over 3 years straight
Caregivers and parents play a huge part in their child’s recovery through pain management and encouraging children to stay hydrated.
During the tonsillectomy
While every surgery has some risks, tonsillectomy is a very common and safe operation. In fact, it is the second most common surgery performed on children. The surgery itself usually takes around an hour. During the surgery, children are placed under anesthesia, or put “ to sleep” with medicine, so they don’t feel anything. Many children will go home the same day.
After a tonsillectomy
The recovery period will vary depending on each child. After the surgery, your child will have scabs on the back of his or her throat. Some children will have bleeding that will need to be monitored and cleaned up. Pain after the surgery can be significant, typically lasts for around 7 to 10 days, but can last for up to 3 weeks after surgery. The doctor will likely provide a prescription to help your child feel more comfortable. Staying hydrated and drinking plenty of fluids after surgery is important. They will also recommend your child take it easy for a while to recover. Once your child is feeling better after surgery he or she can eat, drink, talk, swim and play just the same as before the removal.
Generally, after a tonsillectomy, there aren’t negative impacts to life. The immune system will function just fine without the tonsils. Your child may see fewer episodes of strep throat, although it may still happen. Your child may have better sleep and less snoring.
Obstructive Sleep Apnea or frequent sore throats can have a major impact on a child’s life. If your child is having problems with their breathing at night, or experiencing very frequent sore throats, it may be worth talking about it with your child’s primary care provider. They can help you consider your options and consider a referral to a Children’s Mercy ENT provider, if needed.
Medical Director, Tracheostomy Program; Assistant Professor of Surgery, University of Missouri-Kansas City School of Medicine; Clinical Assistant Professor of Otorhinolaryngology, University of Kansas School of Medicine