Tonsillectomy / Adenoidectomy in Children
The tonsils are two grape sized structures in children at the back of the throat and contribute to the immune system. The adenoids are made of similar tissue at the back of the nose behind the soft palate. If tonsils and adenoids are causing problems such as tonsillitis (see tonsillitis) and /or obstructed breathing at night (see sleep apnoea) then they can be considered for removal. This is performed during a general anaesthetic whilst the child is asleep and this is often a day case procedure. Patients with a history of sleep apnoea usually need to be observed overnight. There is no significant reduction in a child’s immunity as a consequence of their removal.
There are some some straightforward instructions for after the operation. The most important issue is for a child to take their painkillers regularly (paracetamol and ibuprofen). This is for at least the first 5 days after the operation as often the pain becomes worse before it gets better around day 5. A child must eat regularly (‘little but often’) as this actually helps with the pain as it prevents spasm of the muscles in the throat which can contribute to discomfort. It also helps with the healing process to wash away the ‘slough’. This is the white material that can be seen after tonsils are removed and are a normal part of healing process.
The main concern regarding this operation is bleeding. Bleeding can occur immediately after the operation or 10 days or more afterwards until the area has fully healed. It is important that parents recognise this as a possible risk in all cases. The risk is approximately 3% so is not common but does occur occasionally. The other risk is injury to the teeth and lips so please mention if there are loose teeth at the time of the operation.