Tonsillectomy and Adenoidectomy

What is a tonsillectomy and adenoidectomy?

Tonsils are small, round pieces of tissue located in the back of the mouth on both sides of the throat. Adenoids are similar to tonsils but located in back of the nasal cavity.

Tonsils and adenoids are often removed when they become large and inflamed and begin to cause frequent infections. The procedure to remove tonsils is known as a tonsillectomy, and removal of the adenoids is called an adenoidectomy. Because they are often removed at the same time, the procedure is referred to as a tonsillectomy and adenoidectomy, or T&A. The surgery is most commonly performed in children.

Tonsillotomies

A tonsillotomy is the partial removal of the tonsils. Studies have shown that, compared to a full tonsillectomy, children often recover more quickly with less pain after a tonsillotomy. Both procedures relieve upper airway obstruction, however, some children’s tonsils grow back after a tonsillotomy, and their symptoms return.

What are tonsillitis and adenoiditis?

Adenoiditis happens when adenoids become inflamed from infection.

The symptoms of tonsillitis vary greatly depending on the cause of the infection, and can occur either suddenly or gradually. The following are the most common symptoms of tonsillitis. However, each child may experience symptoms differently. Symptoms may include:

sore throat
fever (either low-grade or high-grade)
headache
decrease in appetite
not feeling well
nausea and vomiting
stomach aches
painful swallowing
visual redness or drainage in the throat

The symptoms of tonsillitis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

The symptoms of adenoiditis vary greatly depending on the cause of the infection, and can occur either suddenly or gradually. The following are the most common symptoms of adenoiditis. However, each child may experience symptoms differently. Symptoms may include:

breathing through the mouth
noisy breathing
snoring
nasal speech
periods at night when breathing stops for a few seconds

The symptoms of adenoiditis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

Some children may be referred to an ear, nose, and throat surgeon to have the tonsils and adenoids removed.

Why would my child need a T&A?

A T&A may be recommended if your child has repeated tonsil and adenoid infections caused by inflammation that do not respond to more conservative treatments.

Your doctor may decide a T&A is the best option if the tonsils and adenoids are causing a functional problem, such as:

obstructive sleep apnea
recurrent infections
tonsil stones
trouble swallowing
tumor in the throat or nasal passage
bleeding from the tonsils that cannot be stopped
significant blockage of the nasal passage and uncomfortable breathing

The American Academy of Otolaryngology offers these guidelines to determine if a child should have a T&A.

seven sore throats in one year
five sore throats in each of two years
three sore throats in each of three years

The sore throats may be associated with the following:

fever
discharge on the tonsils
positive strep throat culture

What happens during T&A?

Most T&A surgeries are done on an outpatient basis. This means your child will have surgery and then go home the same day. During the surgery, your child will be anesthetized in the operating room. The surgeon will remove your child's tonsils and adenoids through the mouth. There will be no cut on the skin.

In most cases, after the surgery, your child will go to a recovery room where they can be monitored closely. After your child is fully awake and doing well, the recovery room nurse will bring your child back to the day surgery area.

At this point, if everything is going well, you and your child will be able to go home. If your child is going to stay the night in the hospital, your child will be brought from the recovery room to their room.

What are the risks of having a tonsillectomy and adenoidectomy?

Any type of surgery poses a risk to a child. About 5 percent of children begin bleeding from the surgery site about five to eight days after the surgery and may require additional blood and/or surgery. Some children may have a change in the sound of their speech due to the surgery. The following are some of the other complications that may occur:

bleeding (may happen during surgery, immediately after surgery, or at home)
dehydration (due to decreased fluid intake; if severe, fluids through an intravenous, or IV, catheter in the hospital may be necessary)
fever
difficulty breathing (swelling of the area around the surgery; may be life threatening if not treated immediately)

How do I care for my child after a tonsillectomy and adenoidectomy?

We recommend the following:

increased fluid intake
pain medication, as prescribed
no heavy or rough play for a duration of time recommended by the surgeon

Download: Home care instructions after a tonsillectomy and adenoidectomy family education sheet