Patient education: Tonsillectomy and adenoidectomy in children (The Basics)

What is a tonsillectomy or an adenoidectomy? — A tonsillectomy is surgery to remove the tonsils. These are areas of soft tissue in the back of the throat (figure 1). An adenoidectomy is surgery to remove the adenoids. Adenoids are also areas of soft tissue in the throat. They are located higher up than the tonsils.

Doctors can do just a tonsillectomy, just an adenoidectomy, or both. When the tonsils and adenoids are both removed, it is called an "adenotonsillectomy," or "T and A" for short. The type of surgery depends on the symptoms and other factors.

Why might a child need a tonsillectomy or adenoidectomy? — There are a few reasons. The 2 most common include:

●Sleep apnea – Large tonsils and adenoids can keep a child from breathing normally when they are asleep. If someone stops breathing for short periods during sleep, doctors call it "sleep apnea." Children with severe sleep apnea can have problems growing and learning. They can also have heart and lung problems if the sleep apnea is not treated.

●Many throat or ear infections – If other treatments do not help, surgery might be an option.

What do tonsillectomy and adenoidectomy involve? — Before surgery, your child's doctor will give you instructions about what to do. Children should not eat or drink for a certain number of hours before surgery.

Most children can go home a few hours after surgery. The doctor will tell you if your child needs to stay overnight for any reason.

Just before the surgery starts, the doctor will give your child medicine to make them fall asleep. Then the doctor will take out the tonsils, adenoids, or both.

What can I expect after my child's surgery? — Your child might have an upset stomach and throw up for 1 or 2 days. They will also have a very sore throat for a few days. A child who has just an adenoidectomy usually has less pain and feels better faster after surgery.

Your child will need to stay home from school for a few days after surgery. The doctor will tell you when your child can go back to school.

Your child should avoid sports and very active play for at least 2 weeks. They should also stay away from people with colds, coughs, and the flu for 2 weeks after surgery.

Most children have bad breath after tonsillectomy or adenoidectomy. This is normal. It usually goes away within 2 weeks.

What can I do to help my child feel better? — To help your child feel better after surgery, you can give them:

●Plenty of liquids – This can be water, juice, broth, or an electrolyte solution that you buy in a store or pharmacy (such as Pedialyte or Gatorade). Your child might not feel like drinking, but it's important that they get enough liquids.

●Medicines – Acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin) can help with throat pain. The correct dose depends on your child's weight, so ask your child's doctor how much to give.

Do not give aspirin or medicines that contain aspirin to children younger than 18 years. In children, aspirin can cause a serious problem called Reye syndrome. Aspirin also increases the risk of bleeding after surgery.

●Foods that are easy to swallow – Such as soft bread, Jell-O, mashed potatoes, pudding, and applesauce.

When should I call my child's doctor or nurse? — After surgery, call your child's doctor or nurse if your child:

●Has bright red blood coming from the nose or throat – A little blood in saliva or vomit is normal after surgery. If you see a lot of bright red blood, take your child to the hospital right away.

●Cannot drink liquids

●Has vomiting that does not get better

●Gets a fever

●Has a severe sore throat or ear pain that doesn't get better after a week or two or gets worse

More on this topic

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Patient education: Ear tubes (The Basics)
Patient education: Eustachian tube problems (The Basics)
Patient education: Strep throat in children (The Basics)
Patient education: Sleep apnea in children (The Basics)

Patient education: Ear infections (otitis media) in children (Beyond the Basics)
Patient education: Sore throat in children (Beyond the Basics)