Tonsillectomy and Adenoidectomy
Many children have health issues that require the removal of their tonsils, adenoids or both. We know you are the ultimate protector of your children’s health, and it can be overwhelming to find the best place to treat enlarged tonsils and/or adenoids.
In this segment of American Health Journal, Dr. Gupreet Ahuja, physician at CHOC, describes the difference between tonsils and adenoids, and goes on to tell us what the reasons would be for removal.
What are tonsils and adenoids?
The tonsils are part of the body’s immune system. Specifically, they are two oval-shaped masses of tissue in the back of the throat that trap germs that could enter the body’s airway and cause an infection. Tonsils also produce antibodies to fight infection. Sometimes, they get infected and swollen, and lead to a condition common in kids called tonsillitis. The adenoids are small pads of lymphoid tissue like tonsils, located in the upper portion of the throat, behind the nose. They serve a similar purpose as the tonsils. “The majority of the time if we are removing the tonsils for obstruction or blockage, we remove the tonsils and adenoids,” says Dr. Ahuja.
When should tonsils be removed?
Tonsils are removed much less frequently than in the past, but removal may be necessary under specific circumstances.
The primary reason for tonsil removal is obstruction or difficulty breathing, sleep-disordered breathing, or sleep apnea. The second reason is recurring infection. Tonsils may need to be removed if a child has seven tonsillar infections in one year, or five infections each year for two years, or three infections each year for three or more years, with the infections being accompanied by one or more of the following features:
- A fever of 1010F or above;
- a strep throat infection confirmed on a swab from the throat;
- white coating on the tonsils;
- large lymph nodes;
- mouth sores.
Surgical removal of the tonsils is called a tonsillectomy. Surgery should be considered only when necessary, but in appropriate situations, it can make a substantial difference in the quality of life.
What procedures are offered to remove my child’s tonsils?
Tonsillectomy is one of the most common procedures performed on children in the United States. Traditionally, the tonsils are completely removed and exposes the muscles surrounding the throat. As a result, kids are in considerable post-operative discomfort and pain, especially when trying to eat after surgery. In addition, there is a risk of bleeding when the scab heals and falls off.
The ENT team at CHOC offers intracapsular tonsillectomy (IT) as an alternative. In this procedure, a small portion of the tonsils are left behind. The remaining tonsils cover the muscles surrounding the throat, which makes eating dramatically less painful with lower risk of bleeding after surgery. In contrast to the traditional method, an IT procedure involves much less pain, earlier return to regular diet, smaller chances of readmission due to dehydration and much lower risk of postoperative bleeding.
Do the tonsils regrow?
The regrowth rate of intracapsular tonsillectomy at CHOC procedure is 0.5-1%.
Does an intracapsular tonsillectomy take longer than a traditional tonsillectomy?
No. The procedure takes the same amount of time, 30 to 45 minutes.
Has this procedure been practiced in other places?
Intracapsular tonsillectomy is growing in popularity in the United States. Elsewhere in the world such as Sweden, this procedure is the preferred method of tonsil removal.
Does my child need pain medication after this procedure?
Usually children will require only over-the-counter pain medication for a few days after surgery. Some children do not even require any pain medication.
How old does my child have to be for intracapsular tonsillectomy?
There are no age restrictions for this procedure.
To learn if intracapsular tonsillectomy is the right choice for your child, please make an appointment.