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Tonsillectomy and Adenoidectomy in Children

Healthcare providers are not in complete agreement about when a child should have a tonsillectomy or adenoidectomy. But here are some guidelines that are followed.

Tonsillectomy

A tonsillectomy may be recommended if your child has throat infections that keep coming back. A throat infection means your child has a sore throat with fever. Or he or she also has swollen neck glands or drainage from the tonsils. Or your child also has a positive strep test. Your child has any of the following:

  • 7 or more throat infections in 1 year
  • 5 or more throat infections in each of 2 years
  • 3 or more throat infections in each of 3 years

A tonsillectomy may also be recommended if your child has recurrent throat infections and any of these:

  • Is unable to take antibiotic medicine or has antibiotic medicine allergies
  • Has episodes of fever, sores in the mouth, sore throat, and swollen neck glands
  • Has had an infected area near the tonsils

A tonsillectomy may also be recommended if your child has:

  • Abnormal breathing while sleeping with enlarged tonsils. This might be brief episodes where your child stops breathing.
  • Very large tonsils that block breathing through the nose or cause difficulty swallowing

Adenoidectomy

Adenoidectomy is recommended if your child has a lot of trouble breathing through the nose. It may also be recommended if your child has:

  • A long-term (chronic) sinus infection
  • Middle ear infections that keep coming back
  • A chronic middle ear infection with fluid and already has ear tubes

Your child will probably have the surgery as an outpatient. That means that he or she will go home the same day as the surgery. The surgery usually takes between 30 and 45 minutes. Your child will get medicine to sleep during the surgery (general anesthesia). Some children may need to stay overnight. This may include children who:

  • Are not drinking well after surgery
  • Have other health problems
  • Have complications after surgery, such as bleeding
  • Are younger than age 3
  • Have sleep apnea diagnosed by a sleep study

In general, the surgery will go as follows:

  • Your child will be given general anesthesia.
  • Medicines and fluids will be given by IV.
  • The ENT will remove your child’s tonsils and adenoids through the mouth. There will be no cut on the skin.