Spanish Version
 
E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

Tonsillectomy

Tonsils removal; Tonsillitis - tonsillectomy; Pharyngitis - tonsillectomy; Sore throat - tonsillectomy

Tonsillectomy is a surgery to remove the tonsils.

The tonsils are glands at the back of your throat. The tonsils are often removed along with the adenoid glands. That surgery is called adenoidectomy and is most often done in children.

Description

The surgery is done while the child is under general anesthesia. Your child will be asleep and pain-free.

  • The surgeon will place a small tool into your child's mouth to hold it open.
  • The surgeon then cuts, burns, or shaves away the tonsils. The wounds heal naturally without stitches.

After surgery, your child will stay in the recovery room until he or she is awake and can breathe easily, cough, and swallow. Most children go home several hours after this surgery.

Why the Procedure Is Performed

The tonsils help protect against infections. But children with large tonsils may have problems breathing at night. The tonsils may also trap excess bacteria which can lead to frequent or very painful sore throats. In either of these cases, the child's tonsils have become more harmful than protective.

You and your child's health care provider may consider a tonsillectomy if:

  • Your child has infections often (7 or more times in 1 year, or 5 or more times over 2 years).
  • Your child misses a lot of school.
  • Your child has trouble breathing and does not sleep well because the tonsils block the airway (sleep apnea).
  • Your child has an abscess or a growth on the tonsils.

Risks

The risks for any anesthesia are:

The risks for any surgery are:

  • Bleeding
  • Infection

Rarely, bleeding after surgery can go unnoticed and cause very bad problems. Swallowing a lot may be a sign of bleeding from the tonsils.

Another risk includes injury to the uvula (soft palate).

Before the Procedure

Your child's provider may ask your child to have:

  • Blood tests (complete blood count, electrolytes, and clotting factors)
  • A physical exam and medical history

Always tell your child's provider what drugs your child is taking. Include any drugs, herbs, or vitamins you bought without a prescription.

During the days before the surgery:

  • Ten days before the surgery, your child may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), warfarin (Coumadin), and other drugs like these.
  • Ask your child's provider which drugs your child should still take on the day of the surgery.

On the day of the surgery:

  • Your child will most often be asked not to drink or eat anything for several hours before the surgery.
  • Give your child any drugs you have been told to give with a small sip of water.
  • You will be told when to arrive at the hospital.

After the Procedure

A tonsillectomy is most often done in a hospital or surgery center. Your child will go home the same day as the surgery. Children rarely need to stay overnight in the hospital for observation.

Complete recovery takes about 1 to 2 weeks. During the first week, your child should avoid people who are sick. It will be easier for your child to become infected during this time.

Outlook (Prognosis)

After surgery, the number of throat infections is most often lower, but your child may still get some.

References

Goldstein NA. Evaluation and management of pediatric obstructive sleep apnea. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 184.

Wetmore RF. Tonsils and adenoids. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 383.

  • After your child's tonsil or adenoid surgery

    After your child's tonsil or adenoid surgery

    Animation

  •  

    After your child's tonsil or adenoid surgery - Animation

    Now that your child's had a tonsillectomy or adenoidectomy what do you do when you go home? I'm Dr. Alan Greene and I want to give you some tips for going home with a child who's just had surgery. First thing to expect is your child's not going to be feeling great for a week or two, especially that first week they may still have pretty significant throat pain and may feel lower energy. So plan a pretty easy week or maybe 2 weeks after the surgery. When it comes to diet one of the most important things is getting plenty to drink. So you want lots of popsicles, fluids, juices, but avoid real citrusy or acidic juices. This isn't the time for lemonade. You also want foods that are soft going down and not crunchy or spicy. So things like jello can be good, ice cream. I still remember sherbet after my tonsillectomy when I was 4-years-old, it was wonderful. Pasta can be good, mashed potatoes, you want to avoid though toast. Toast is great after a tummy ache perhaps, but it can be really scratchy on the raw throat after a tonsillectomy. Also want to avoid really spicy foods. Now your doctor may have prescribed some medication, perhaps some for pain and perhaps some antibiotics and those should be taken regularly as prescribed. And you want to make sure and call your physician if the pain is severe and is not relieved by the pain medications that were given to you. Or if there is bright red bleeding. A little oozing afterwards is normal, but if there's a lot of bleeding it should be looked into. Or if there's real difficulty swallowing even those mashed foods or any difficulty breathing would be reasons to get back in touch with the doctor.

  • Before a child's tonsil or adenoid surgery

    Before a child's tonsil or adenoid surgery

    Animation

  •  

    Before a child's tonsil or adenoid surgery - Animation

    When your child is having surgery it feels like a big deal. I know that as a Dad. But I'm also a pediatrician. I'm Dr. Alan Greene and I want to talk to you about how to prepare for tonsillectomy and adenoidectomy. Perhaps the first thing is preparing yourself because if you're feeling confident and good about the surgery, then everything will go much easier for you and for your child. And that means getting your questions answered beforehand. And in particular, the question I hear the most from parents is concern about the anesthesia. And that comes often from anesthesia risks that happened back when we were children. Anesthesia was much more dangerous than it is today. The problem was there weren't ways to monitor whether kids were getting enough oxygen to the brain or not. But since those monitors were developed about 20 years or so ago now, anesthesia has become incredibly safe - in fact, often safer than driving to the hospital. Now there other things that are important to do to prepare. First is to remember to take notice if your doctor has ordered any lab tests before the surgery. Perhaps blood tests, perhaps urine tests, maybe nothing was needed. But if it was, you want to make sure you've gotten it done before you end up going to the hospital. The second thing are instructions should've been given to you about when is the last time your child could eat or drink before heading to the hospital. Often it'll be midnight the night before, but whatever you were told be sure to take note of that and really don't cheat on this one. Nothing after what they say. And that leads to point number 3. Whatever medications that your child is taking, prescribed medicines, over-the-counter medicines, need to be taken into account. So, make sure you discuss with your physician, your anesthesiologist or the surgeon beforehand whatever medicines your child is taking and whether they should be taken or skipped after that deadline for food and drink. Next thing that's important, number 4, is to help your child select a favorite toy or stuffed animal, action figure to bring with them to the hospital. This little dog here or something that's comforting for them to have with them along the way. And it's a great idea before the whole thing depending on the age and temperament of your child to act out the whole scenario using their favorite toy. So, for instance, this little dog is not feeling well, hasn't been feeling well for awhile, has to take lots of medications, but the doctors are going to be able to fix it. Can't eat or drink anything after midnight - every step of it you go through. They're a little bit scared and they find out everything is fine and it worked out great and they get some ice cream afterwards and the problem is all gone. But to work it through with them so they get the story and it also helps you feel more prepared. I also suggest giving children something specific and fun to look forward to shortly after the surgery. It might be something as simple as a trip to the movies together or a trip to get ice cream but something that they can focus on. Take the focus a little bit off the surgery itself. Not a bad thing for you too. Then a couple of practical things. I do suggest that before going in you take off any jewelry that the child has, you bathe them, you get rid of even earrings that may stay in all the time or hair clips that may, you don't really want those at the hospital. And it's good to choose comfortable clothes when you go to the hospital, things that are easy on, easy off. It's not a fashion show. Although you may want some pictures of this cause it is a kind of historic moment. And lastly, if your child does develop any kind of fever or rash or cold beforehand, make sure to give them a call and let the folks know what's going on cause it may mean the surgery should be postponed. But the good news is that this kind of minor surgery today in children is extraordinarily safe and when it's done for the right child at the right time really helps move them ahead, move the family ahead. Most parents are really glad afterwards that the surgery has been done.

  • Throat anatomy

    Throat anatomy - illustration

    Structures of the throat include the esophagus, trachea, epiglottis and tonsils.

    Throat anatomy

    illustration

  • Tonsillectomy - Series

    Tonsillectomy - Series

    Presentation

  • After your child's tonsil or adenoid surgery

    Animation

  •  

    After your child's tonsil or adenoid surgery - Animation

    Now that your child's had a tonsillectomy or adenoidectomy what do you do when you go home? I'm Dr. Alan Greene and I want to give you some tips for going home with a child who's just had surgery. First thing to expect is your child's not going to be feeling great for a week or two, especially that first week they may still have pretty significant throat pain and may feel lower energy. So plan a pretty easy week or maybe 2 weeks after the surgery. When it comes to diet one of the most important things is getting plenty to drink. So you want lots of popsicles, fluids, juices, but avoid real citrusy or acidic juices. This isn't the time for lemonade. You also want foods that are soft going down and not crunchy or spicy. So things like jello can be good, ice cream. I still remember sherbet after my tonsillectomy when I was 4-years-old, it was wonderful. Pasta can be good, mashed potatoes, you want to avoid though toast. Toast is great after a tummy ache perhaps, but it can be really scratchy on the raw throat after a tonsillectomy. Also want to avoid really spicy foods. Now your doctor may have prescribed some medication, perhaps some for pain and perhaps some antibiotics and those should be taken regularly as prescribed. And you want to make sure and call your physician if the pain is severe and is not relieved by the pain medications that were given to you. Or if there is bright red bleeding. A little oozing afterwards is normal, but if there's a lot of bleeding it should be looked into. Or if there's real difficulty swallowing even those mashed foods or any difficulty breathing would be reasons to get back in touch with the doctor.

  • Before a child's tonsil or adenoid surgery

    Animation

  •  

    Before a child's tonsil or adenoid surgery - Animation

    When your child is having surgery it feels like a big deal. I know that as a Dad. But I'm also a pediatrician. I'm Dr. Alan Greene and I want to talk to you about how to prepare for tonsillectomy and adenoidectomy. Perhaps the first thing is preparing yourself because if you're feeling confident and good about the surgery, then everything will go much easier for you and for your child. And that means getting your questions answered beforehand. And in particular, the question I hear the most from parents is concern about the anesthesia. And that comes often from anesthesia risks that happened back when we were children. Anesthesia was much more dangerous than it is today. The problem was there weren't ways to monitor whether kids were getting enough oxygen to the brain or not. But since those monitors were developed about 20 years or so ago now, anesthesia has become incredibly safe - in fact, often safer than driving to the hospital. Now there other things that are important to do to prepare. First is to remember to take notice if your doctor has ordered any lab tests before the surgery. Perhaps blood tests, perhaps urine tests, maybe nothing was needed. But if it was, you want to make sure you've gotten it done before you end up going to the hospital. The second thing are instructions should've been given to you about when is the last time your child could eat or drink before heading to the hospital. Often it'll be midnight the night before, but whatever you were told be sure to take note of that and really don't cheat on this one. Nothing after what they say. And that leads to point number 3. Whatever medications that your child is taking, prescribed medicines, over-the-counter medicines, need to be taken into account. So, make sure you discuss with your physician, your anesthesiologist or the surgeon beforehand whatever medicines your child is taking and whether they should be taken or skipped after that deadline for food and drink. Next thing that's important, number 4, is to help your child select a favorite toy or stuffed animal, action figure to bring with them to the hospital. This little dog here or something that's comforting for them to have with them along the way. And it's a great idea before the whole thing depending on the age and temperament of your child to act out the whole scenario using their favorite toy. So, for instance, this little dog is not feeling well, hasn't been feeling well for awhile, has to take lots of medications, but the doctors are going to be able to fix it. Can't eat or drink anything after midnight - every step of it you go through. They're a little bit scared and they find out everything is fine and it worked out great and they get some ice cream afterwards and the problem is all gone. But to work it through with them so they get the story and it also helps you feel more prepared. I also suggest giving children something specific and fun to look forward to shortly after the surgery. It might be something as simple as a trip to the movies together or a trip to get ice cream but something that they can focus on. Take the focus a little bit off the surgery itself. Not a bad thing for you too. Then a couple of practical things. I do suggest that before going in you take off any jewelry that the child has, you bathe them, you get rid of even earrings that may stay in all the time or hair clips that may, you don't really want those at the hospital. And it's good to choose comfortable clothes when you go to the hospital, things that are easy on, easy off. It's not a fashion show. Although you may want some pictures of this cause it is a kind of historic moment. And lastly, if your child does develop any kind of fever or rash or cold beforehand, make sure to give them a call and let the folks know what's going on cause it may mean the surgery should be postponed. But the good news is that this kind of minor surgery today in children is extraordinarily safe and when it's done for the right child at the right time really helps move them ahead, move the family ahead. Most parents are really glad afterwards that the surgery has been done.

  • Throat anatomy

    Throat anatomy - illustration

    Structures of the throat include the esophagus, trachea, epiglottis and tonsils.

    Throat anatomy

    illustration

  • Tonsillectomy - Series

    Presentation

 

Review Date: 8/1/2017

Reviewed By: Ashutosh Kacker, MD, FACS, Professor of Clinical Otolaryngology, Weill Cornell Medical College, and Attending Otolaryngologist, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com

 
 
 

 

 

A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Content is best viewed in IE9 or above, Firefox and Google Chrome browser.