The tonsils are small, oval pieces of tissue that are located in the back of the mouth on the side of the throat. Tonsils help fight infection by producing antibodies. The tonsils can usually be seen in the throat of your child by using a light. Tonsillitis occurs when the tonsils become inflamed from infection.
Adenoids are similar to the tonsils. The adenoids are made up of lymph tissue and are located in the nasopharynx, the space above the soft roof of the mouth. They cannot be seen by looking in your child's nose or throat. Adenoids also help to fight infections. Adenoids may cause problems if they become enlarged or infected.
Adenoiditis occurs when the adenoids become inflamed from infection.
Surgical removal of the tonsils and/or adenoids may be necessary when they enlarge to cause upper airway obstruction (OSA) or become recurrently infected (Pharyngitis-Tonsillitis).
This surgery is called a tonsillectomy and adenoidectomy (T&A). Often, the tonsils and adenoids are removed at the same time, but sometimes only the tonsils or the adenoids are removed. Your child's physician will discuss this with you.
The following are some of the more widely accepted reasons for having a T&A
The following are some of the Guidelines for T&A from the American Academy of Otolaryngology-Head and Neck Surgery:
The following are more controversial reasons for the removal of the adenoids and/or tonsils:
The following are some situations that DO NOT require removal of the tonsils, although each child will be evaluated on an individual basis:
A T&A will not help any of these problems.
Tonsillectomy and adenoidectomy (T&A) surgery is one of the most common major surgery performed on children in the U.S. About 400,000 surgeries are performed each year. The need for a T&A will be determined by your child's ear, nose and throat surgeon and discussed with you.
Most T&A surgeries are done on an outpatient basis. This means that your child will have surgery and then go home the same day. Some children may be required to stay overnight, including children who:
Before the surgery, you will meet with different members of the healthcare team who are going to be involved with your child's care. These may include:
During the surgery, your child will be anesthetized in the operating room. The surgeon will remove your child's tonsils and/or 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 she or he can be monitored closely. After the child is fully awake and doing well, the recovery room nurse will bring the 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, the child will be brought from the recovery room to his or her room. Usually, the parents are in the room to meet the child.
Bleeding is a complication of this surgery and should be addressed immediately by the surgeon. If the bleeding is severe, the child may need to return to the operating room.
The following are some of the instructions that may be given to you to help care for your child:
Any type of surgery poses a risk to a child. About 2-3 percent of the children may have bleeding from the nose and/or mouth when the scabs separate from the operative site, usually five to seven days after surgery. Some children may have a change in the sound of their speech due to the surgery related to the absence of the tonsils and/or adenoids.
The following are some of the other complications that may occur:
Reviewed by: Steven D. Handler, MD, MBE
Date: April 2009