What Parents Should Know About Tonsillectomy and Adenoidectomy
Tonsil and adenoid surgeriesarethe most common surgical proceduresperformed on children in the United States.Tha’s been truefor about the last 20 years, saysVikash K Modi, MD,Chief of Pediatric Otolaryngology - Head and Neck Surgeryat سԹ. Dr. Modi, alsoAssociate Professor of Otolaryngology in Pediatrics at Weill Cornell Medical College, reports that about 75 percent of his practice comprises pediatric tonsiland adenoid surgery.
HereDr. Modiexplainswhentonsil and adenoid surgeryare necessary, and what families need to know about the procedures.
Tonsil and adenoid response to infections
Tonsils are located on both sides of the back of the throat,and adenoids are located in the back of the nose.
“Often, in response to infection,or for other reasons, the tonsils will enlarge,and you can see them as two large balls of tissue on either side of the throat,” Dr. Modi explains. į
Adenoid tissue may enlarge in response to respiratory tract infections, allergies, orsometimesfor unknown reasons.
Common reasons for tonsil and adenoid surgeries
There are twocommon reasonsfor tonsil and adenoid surgery:infection and upper airway obstruction.
Frequent throat infection—most commonly, strep throat—is an indication for tonsillectomywhen achild has had seven or more episodes in one year, five episodes in two successive years, or three episodes in three successive years. į
Physicians may recommend a partial or total tonsillectomywhen the tonsils and/or adenoids become enlarged andobstruct theairway.
“Parents should watch for disruptive sleep patterns, such as frequent waking at nightthatoccurswith snoring, or apnea[a cessation of breathing],” Dr. Modi says. “Sometimes parentshear loud, irregular snoring at night,ornotice their child is wettingthe bedormouth-breathing.”
Enlarged adenoids may cause chronic earaches and ear infections, with or without middle ear fluid.
“Adenoid tissue is near the opening of the eustachian tube, which ventilates the middle ear space,” Dr. Modi says. “Large adenoids can block the eustachian tube opening, leading to fluid build-up, ear infections, and hearing loss.” į
Adoctor may recommend an adenoidectomy for a child who experiences long-term or recurrent sinus or nasal infections despite adequate medical treatmentheadds.
When parents notice that their child is more tired than usual oristakingdaytimenaps, it can be asign of possible disrupted sleep and/or sleep apnea.
“Apneacan affect a child's growth and development,” Dr. Modi says. “Disrupted sleep and/or sleep apnea also been closely correlated with learning disabilities,such as ADHD.Long-termsleep apnea can lead to cardiopulmonary issues.”
Surgical options can include tonsil reduction (shaving)or removal.
If a child suffers fromsleep apnea or obstruction,surgeons would typicallyperform apartial tonsillectomywithanadenoidectomy. When the major challenge ischronicthroat infections, they’d be more likely to perform a total tonsillectomy, Dr. Modi says. į
I’s important to prepareachild for these procedures
Sometimes children may be given a sedative before surgery, and anesthesia is administered with a mask. Both may surprise children, so Dr. Modi advises parents to prepare their child for surgery.
Parents are allowed to be with childrenin the operating room untilthechild isasleep, andin the recovery room whenthechild wakes up.
“There are several books that you and your child can read together that would help to prepare for the experience,” Dr. Modi adds. “One example isCurious George Goes to the Hospital, by M & H Rey.”
Tonsillectomies and adenoidectomies are usually outpatient procedures
Sometimes, Dr. Modi explains, achild may stay in the hospital overnight.
Both procedures—which require general anesthesia—are brief. An adenoidectomy usually takes 30 to 40 minutes, and the surgeries performed together usually take between 45 and 60 minutes.
“After a tonsillectomy, children may experience some pain and bleeding,”Dr. Modisays. Bleeding is less frequent with a partialtonsillectomy, and usually occurs closer to the time of the procedure, or about a week later, when a scab falls off the surgical site.
With a partial tonsillectomy, a child may complain of a mild sore throat fortwo to threedays after surgery. Dr. Modi says over-the-counter medications usuallybring relief.
Recovering from surgery
Some children feel better in just a few days, and some take as many as 14 days to recover. į
“During the recovery period, make sure your child stays well hydrated,” Dr. Modi says, and suggestsavoiding carbonated drinks, and acidic drinks (like orange juice).
Asoft diet where chewing is necessaryalso is important: chewing and swallowing relieve pain and promote healing.
Parents may noticeahigh-pitched or squeakychange inthe child’svoice—i’susually temporary,but may lastforsixtoeightweeks.
Children who undergoa partial tonsillectomyusuallyreturn to school when they feel ready, usuallyin three to fivedays.
to stay up to date on all the latest health news and important updates from سԹ.