When Children Need A Tonsillectomy
More than half a million tonsillectomies are performed each year on children in the U.S., making it the second most common surgery for children. Read on to learn if a tonsillectomy is the right decision for your child.
What Is a Tonsillectomy?
Tonsils are two clusters of tissue in the back of the throat, and adenoids are located just behind the nose. Their purpose is to help filter out harmful bacteria and viruses that are breathed in and protect the body from infection. A tonsillectomy is a surgery that removes the tonsils.
Although tonsillectomy is one of the most common surgeries kids and teens have, not all children need this. Large tonsils may shrink on their own over time. Adenoids typically shrink by age seven and are virtually nonexistent by the teen years. However, for some children, tonsils are more trouble than they're worth.
Reasons For Having A Tonsillectomy
One of the main reasons for having a tonsillectomy is the obstruction of the airway. Tonsils and adenoids can grow large enough to block the airway and make it difficult to breathe. Breathing issues can be especially troublesome when a person is lying down, and gravity brings the tonsils down onto the airway. This happens, particularly at night, because the body is in a reclined position. It may lead to obstructive sleep apnea (OSA), which can be severe and lead to health and behavioral problems in children.
Snoring alone isn't enough to diagnose OSA. Apnea means that the person actually stops breathing. Parents should listen for not just snoring but actual pauses in their child's breathing. It can also sound like a choking noise followed by silence. Parents whose children suffer from this often find themselves getting up during the night to adjust their child's position in bed.
The effects of poor sleep also carry over into the daytime. Children may show restless or erratic behavior, irritability, and poor coping skills. Removing tonsils and adenoids to help correct airway obstruction helps many patients no longer experience sleep apnea.
Another reason for having a tonsillectomy is recurring infections. Tonsils help keep bacteria and viruses out, but they are sometimes overwhelmed and become infected themselves. Recurring throat infections mean defenses can't keep up.
The Academy of Otolaryngology-Head and Neck Surgery set new guidelines for children undergoing tonsillectomy. They stress that children should have at least seven episodes of throat infection, such as tonsillitis or strep throat in a year, five episodes each year for two years, or three episodes annually for three years before they become candidates for surgery. These infections should also be documented by a doctor, rather than just reported by parents.
The good news is that surgeries to remove tonsils and adenoids are among the most common outpatient pediatric surgeries and most children recover quickly. At home, Tylenol® or ibuprofen can help manage pain, and patients usually recover in seven to 10 days.
If your child has frequent throat infections (like strep throat) that include a fever and swollen lymph nodes lasting for three or four days, talk with your doctor about whether a tonsillectomy and adenoidectomy would help.
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