Tonsillectomy

What is a tonsillectomy?

Tonsillectomy is surgery to take the tonsils out. Tonsils are lymphoid tissue that are located on both sides of the back of the throat.

The adenoid may also be taken out at the same time as the tonsils. The adenoid is lymphoid tissue located behind the nose. Surgery to remove the tonsils and the adenoid is called an adenotonsillectomy.

Why does my child need a tonsillectomy?

Tonsils may be taken out if they are enlarged. Enlarged tonsils and adenoids can cause trouble breathing during sleep. This is called sleep disordered breathing. Symptoms of sleep disordered breathing include snoring, restless sleep and waking up at night. If your child has these symptoms, a sleep study may be ordered. A sleep study may show pauses in breathing. These pauses in breathing can cause a child’s oxygen levels to drop. This condition is called obstructive sleep apnea.

Tonsils and adenoids are taken out if they get infected often. Tonsils may get inflamed or swollen, which is called tonsillitis. Tonsillitis can be caused by a viral or bacterial infection, such as strep.

Tonsils may also be removed if they are enlarged and cause feeding and swallowing problems. A child may prefer liquids or soft foods over solid food if they have swallowing problems.

What other treatment options are there for my child?

If your child has sleep disordered breathing, the doctor may recommend a trial of medicine, such as steroid nasal spray.

Another treatment option for obstructive sleep apnea involves keeping the throat open to improve air flow with a device called continuous positive airway pressure (CPAP). During CPAP treatments, a child wears a nose mask that supplies extra air to keep the airways open. Other treatment options include maxillary expanders and oral appliances such as mouth pieces prescribed by a dentist or orthodontist.

Your child may be given medicines to treat bacterial infections that cause tonsillitis.

How do I help prepare my child for a tonsillectomy?

There are several ways that you can prepare your child for surgery – from explaining the surgery to your child, to making sure your child is prepared for the day of surgery. In addition to listening to our patients and families share their stories, the below are some ways that you can help your child be ready on the day of surgery.

Medicines

For two weeks before a tonsillectomy, your child should not take ibuprofen (Motrin® or Advil®). Your child should also not take herbs called St. John’s Wort or Gingko Biloba.

Eating and drinking

Your child’s providers will tell you when your child should stop eating and drinking before surgery. Your child should not eat or drink too close to the time of surgery. If your child’s stomach is not empty at the time of anesthesia, the stomach contents can come up and enter the lungs. This is called aspiration, which can cause serious health problems.

The surgery will be rescheduled if your child eats or drinks too close to the time of surgery.

Your child should not have any gum, candy or mints on the day of surgery.

What happens during a tonsillectomy?

A tonsillectomy is done under general anesthesia and takes about 45 minutes. General anesthesia helps your child fall into a deep, sleep-like state that protects them from pain during surgery.

Your child’s tonsils will be removed and taken out through the mouth.

Your child may stay in the hospital for two to four hours after a tonsillectomy. In some cases, your child may stay overnight for observation.

What can we expect after my child’s tonsillectomy?

Pain

Throat pain from a tonsillectomy can last for 10 to 14 days. The pain can be moderate to severe, but pain medicine and drinking plenty of liquids can help.

Your child may also have neck pain with decreased neck movement for five to seven days if they also had adenoids removed during surgery.

Your child may also have jaw and tongue pain, which is caused by the special tools used to keep the mouth open during surgery. Ear pain is common and will go away when your child’s throat pain goes away.

Bad breath

Bad breath can last for three to four weeks after the tonsillectomy until the scabs fall off. Your child should continue brushing their teeth, but they should not use mouthwash.

Weight loss

Your child will probably lose some weight after a tonsillectomy because they may not feel like eating. Once your child starts eating normally, they will gain the weight back.

Fever

Your child may have a low-grade fever (less than 101.5°F).

Constipation

Your child may have constipation for several days after surgery. This is caused by taking pain medicines and drinking less than normal. Have your child drink plenty of liquids to manage constipation.

Nausea and/or throwing up

Some children may have an upset stomach or throw up after surgery. This usually gets better within a few hours. It should not last longer than 24 hours after surgery.

How do I care for my child at home after a tonsillectomy?

Limit activity

Limit your child’s activity as directed by the doctor. Many children are able to go back to their normal activities, such as school, within 10 to 14 days after a tonsillectomy. Your child should not return to school if they still need pain medicine, is not eating or drinking well or does not feel well.

Your child should not participate in contact sports, rough play or swimming for two weeks after surgery. Your child should also not travel for two weeks after surgery.

Control pain

Your child will be prescribed medicine for pain. Follow the surgeon’s instructions on how to give this medicine to your child.

There are other things you can do to help control your child’s pain. You can apply cool or warm compresses on your child’s neck. Ice chips and cool liquids can help to soothe your child’s throat. A warm compress can help to relieve ear pain. Frequent chewing can help decrease jaw pain.

Help with drinking and eating

It's very important that your child drink as much liquid as possible to prevent dehydration and decrease pain. Drinking helps your child heal and helps their throat feel better. Have your child drink water, sports drinks and fruit juices (except citrus juice, which can hurt the throat). Children under two years of age should have Pedialyte®. You can also give your child popsicles, Jell-O® and ice cream. These count as liquids.

Do not let your child have soda and other carbonated drinks. They can make your child’s throat hurt more.

It is normal for your child not to feel like eating very much after a tonsillectomy. Drinking liquids is most important. Feed your child foods that are easy to swallow and do not cause pain. Avoid spicy foods, citrus fruits and crunchy foods.

Read more tips on how to help your child adjust after surgery.

Why choose Children’s Hospital Colorado for my child’s tonsillectomy?

At Children’s Colorado, we specialize in pediatric care. From the moment you walk into our hospital, we are focused on providing a pleasant and kid-friendly experience for your child.

We have a dedicated team of pediatric otolaryngology doctors, anesthesiologists, nurses and child life specialists who work together to make your child’s surgery as comfortable as possible.

Learn more about Ear, Nose and Throat services at Children's Colorado.