Tonsillectomy: What to Expect

In my last post, Tonsillitis and How to Know When Your Child Has It, I discussed the symptoms of tonsillitis for parents and also shared that this is often treated with a tonsillectomy.

This post focuses on this common surgical procedure, providing parents and kids information about what to expect if your child's pediatrician recommends a tonsillectomy.

What happens during a tonsillectomy?

A tonsillectomy is a surgical procedure to remove (this is what's referred to by the term “ectomy”) entire tonsils. Sometimes, but not always, the doctor may also choose to do an adenoidectomy to remove the adenoids.

Adenoids are located in the back of the nasal passage where it connects with the airway, while the the tonsils are on either side of the throat. Because a doctor can't see the adenoids in a simple exam, he or she will decide during surgery if they should be removed as well.

Today, there are an estimated 400,000 tonsillectomies done each year. It is the second most common surgery of childhood. Of the approximately 5,000 of these surgeries performed annually at Children's Hospital Los Angeles, ENT specialist, Jeffrey Koempel, MD, MBA, performs about 3,000.

Surgery: What to expect

Today, most tonsillectomies are done as outpatient or day surgeries. This means that you don’t stay in the hospital and can go home the same day. The surgery today takes less than 15 minutes and the usual blood loss is only a drop or two.

Preparing for Surgery

If your child needs to have a tonsillectomy, have the doctor or nurse in the office help prepare your child for this surgery. Depending on age, this can be done in several ways. At Children’s Hospital Los Angeles, we have child life specialists who help prepare children for surgery.

After Surgery

Encourage your child to drink liquids. Dehydration is the most common complication of this surgery. It happens if the child is in too much pain, or for whatever reason, will not drink. About 5 to 10 percent of children need to come back to the Emergency Department for IV hydration because of severe dehydration.

In the first 24 to 48 hours after surgery, it's a good idea to give your child regular pain medication as prescribed before the pain becomes really bad. This will help your child take adequate liquid and food after surgery.

The second most common complication is bleeding and is most often seen about 4-7 days after surgery. While it is rare, be sure to bring your child to the Emergency Department if they are bleeding. Occasionally, the child may have to be readmitted to the hospital for treatment.

Recovery Time

Children usually recover quickly from this operation.

• Ages 2-4: within 1 week
• Ages 4 to pre-teen: in 1 week
• Pre-teens and teens 7-14 days.

After this time period, children are typically back on a regular diet and can resume school or regular activity. It is recommended that for about 14 days after surgery, the child not participate in any active sports due to the risk of bleeding with strenuous activity.

How can I help my child?

If your child is showing any of the signs mentioned in my last blog, which include frequent ear or throat infections, take him or her to their pediatrician or ENT specialist for a thorough examination. Listen to the expert advice given to you about your child's condition.

My Story

I had my tonsillectomy at age 5. In those days, you stayed in the hospital for a couple of days after surgery. I loved the hospital! Even though my throat hurt, I got to eat ice cream and green Jello (my favorite) and all my relatives brought me presents. I cried when I had to go home, but my parents bought me a goldfish and propped my bed up like a hospital bed, helping to ease the transition.

By taking your pediatrician's advice and taking my tips on how to help your child through surgery and their recovery, you can work with your child's health caregivers to help minimize post-surgical complications. Who knows? They may even grow up to have a fond memory of their tonsillectomy like me!