Tonsillectomy and Adenoidectomy

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.

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

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.

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)

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