Is It Time to Have Your Child’s Tonsils Removed — Adenoids Too?

What usually prompts this common surgery

Is It Time to Have Your Child's Tonsils Removed — Adeniods Too?

You might see tonsils as a focus of attention in two situations: 1. You are watching a classic cartoon featuring the long exaggerated scream of a cat, or 2. Your child has repeated throat infections.

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Tonsils, those two clusters of tissue in the back of your throat and adenoids, their counterparts, located just behind the nose, work together to protect our bodies from infection. They help filter out harmful bacteria and viruses that you may breathe in (although adenoids typically shrink by age 7, and are virtually nonexistent by the teen years).

While these tissues serve an important function, for some of us, they’re more trouble than they’re worth.

The good news is that surgeries to remove tonsils (tonsillectomy) and adenoids (adenoidectomy) are among the most common pediatric surgeries — and most children recover quickly.

Knowing what tonsils and adenoids do and why doctors sometimes take them out can help you decide if surgery is the right call for your child, or for you.

When do they need to go?

Although they’re useful, tonsils and adenoids sometimes need to come out.

Pediatric otolaryngologist Brandon Hopkins, MD, says the most common reasons for tonsillectomy and adenoidectomy are airway obstruction and recurring throat infections. (While doctors do these procedures mostly on children, some adults also opt for them as well, he says.)

1.They are affecting your child’s sleep.

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Some children have larger tonsils and adenoids than others, and they sometimes interfere with breathing.

This is a problem particularly at night because the body is in a reclined position. It can cause a serious health condition known as sleep apnea — short periods of time when breathing stops during sleep.

“Symptoms of sleep apnea in children can include snoring at least four nights out of seven, pauses in breathing followed by a ‘catch-up’ breath, restless sleep, sweating, tiredness, and even bed wetting” says Dr. Hopkins.

The effects of poor sleep also carry over into the waking hours. Children may show restless or erratic behavior, irritability and poor coping skills.

“In addition to warding off consequences of sleep deprivation, removing tonsils and adenoids to help correct airway obstruction is so effective that many patients don’t even need to use a CPAP machine (which helps with breathing at night),” says Dr. Hopkins.

For children 3 and older, the surgeon usually removes both tonsils and adenoids. For children younger than 2, surgeons remove only the adenoids, he says.

2. They are causing recurring throat infections.

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Recurring throat infections mean defenses can’t keep up. Tonsils help keep bacteria and viruses out but, because they are one of the body’s first lines of defense, they are sometimes overwhelmed and infected themselves.

If your child has frequent throat infections (strep throat, virus, etc.) that include a fever and swollen lymph nodes and last for three or four days, talk with your doctor about whether a tonsillectomy and adenoidectomy would help.

According to Dr. Hopkins, “frequent” means:

  • Six to seven episodes per year
  • At least five episodes per year in each of the preceding two years
  • More than three episodes per year in each of the preceding three years

How does surgery help?

Surgery to remove tonsils and/or adenoids is usually well-tolerated, with most children going home a few hours later. Tylenol® or ibuprofen help manage pain, and patients usually recover in seven to 10 days, says Dr. Hopkins.

He adds that surgery sometimes also helps with:

  • Nasal obstructions that cause a narrow palate
  • Swallowing issues
  • Tonsil stones (calcified material in the tonsils)
  • Peritonsillar abscess (when infection spreads beyond tonsils)

These are common procedures, averaging more than 530,000 surgeries in the U.S. each year, and they help children and adults breathe (and swallow) easier, Dr. Hopkins says.