Tonsillectomy in children

Tonsillectomy is one of the most common ear, nose and throat (ENT) surgical procedures that your child may need to have when dealing with tonsil problems.

Our surgeons routinely perform tonsillectomies and we are recognised experts in the procedure. Throughout the surgery we will not only ensure your child is fully supported, but also provide you with all the knowledge you need to help them recover at home. 

What is a tonsillectomy?

A tonsillectomy refers to the removal of your child’s tonsils. These are located in the back of their throat, on either side, and work with your child’s immune system to help filter out germs that enter through their nose or mouth.

There are various reasons why your child may need to have their tonsils removed. This includes recurrent infections like tonsillitis, or if their tonsils are causing obstructive symptoms resulting in breathing and sleep problems.

Before a tonsillectomy

Before your child undergoes a tonsillectomy you’ll be advised by the consultant if any medication they take needs to be stopped, as well as when they will need to stop eating and drinking. 

Your child is likely to feel nervous before their surgery, so do your best to keep them calm and let them know what to expect before, during and after the procedure.

During a tonsillectomy

A tonsillectomy is performed by one of our highly skilled ear, nose and throat (ENT) surgeons, supported by a full healthcare team. This wider team will include an anaesthesiologist who will help ensure your child is safe and comfortably asleep (under general anaesthetic) while the procedure is being performed. 

Tonsillectomies usually only take around 30 minutes to complete. This may be longer if the surgery is in combination with other common ENT procedures such as adenoidectomy or grommet insertion.

There are two different methods of performing a tonsillectomy – traditional and intracapsular. 

Traditional tonsillectomies are where both tonsils are completely removed. An intracapsular tonsillectomy is where the affected tonsil tissue is removed but the surrounding capsule of the tonsil is left to help protect the underlying throat. Intracapsular tonsillectomies do carry a risk of regrowth and recurrent tonsillitis, if this occurs further surgery may be required to remove the remaining tonsil. Your surgeon will explain in more detail the risks and benefits of both approaches.

Tonsillectomies are performed through your child’s open mouth so there will be no visible cuts or scars afterwards.

Can I stay with my child during their tonsillectomy?

You’ll be able to stay with your child up until the point the anaesthetic needs to be administered. However, you will then need to return to the waiting room until the surgery has been completed. 

After a tonsillectomy

After their tonsillectomy your child will be taken to the recovery room to wake up. Most children can go home on the same day. However some children may need to stay overnight in hospital for observation, this is particular for young children under three and those with sleep apnoea.

Helping your child recover after a tonsillectomy

Recovering from a tonsillectomy, especially an intracapsular tonsillectomy, can be very quick. However, we usually recommend children to take at least a week off school/nursery with support from a parent/carer. 

They will most likely experience some pain and soreness in their throat which can make it difficult to eat and drink. Therefore, to avoid dehydration you must encourage them to drink water and offer them foods that are easy for them to swallow. 

Some recommended food and drinks include:

• smooth yoghurt
• mashed potatoes
• soup 
• smoothies
• ice cream
• soft fruit

Paracetamol and/or ibuprofen may be recommended to ease your child’s pain and make it easier for them to eat and drink. If this is the case, always follow the recommended dosage for pain relief medication and ask your child’s consultant if you’re not sure. 

Why would my child need a tonsillectomy?

Your child may need a tonsillectomy for a variety of reasons. The most common reason is due to recurrent or chronic tonsillitis.

Tonsillitis can be viral or bacterial, with bacterial being the only type that’s treatable with antibiotics. But, antibiotics or home remedies are not enough on their own if your child keeps developing tonsil infections.

If your child is diagnosed with a tonsil infection multiple times in a short space of time, a tonsillectomy will be recommended.

Another common reason for a tonsillectomy is due to your child’s tonsils becoming enlarged and blocking their airways, often experienced at night when they’re trying to sleep.

If this is the case, your child may develop obstructive sleep apnoea over time – a condition where they will snore and stop breathing for short periods while they sleep.

Tonsillectomy risks in children

Any surgery has potential risks and tonsillectomies are no exception.

The main risk associated with tonsillectomies is infection. With intracapsular tonsillectomies and regular painkillers this impact can be minimised. Our dedicated team ensures only the very best hygiene and practices are followed to reduce the risk of this occurring.

Rarer risks can include anaesthetic complications and bleeding either during or after surgery. If your child coughs or spits out blood after they have got home call for medical attention immediately as they may need further surgery to stop the bleeding. We usually recommend not taking air travel for 2-3 weeks after surgery where possible.