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Tonsil Time

Posted 1/11/2018 by UHBlog

Could removing your child’s tonsils improve their health? Ask us.

Young girl having her tonsils examined

If your child has frequent throat infections or sleep difficulties, you may be thinking “cut it out!” Some children with these health issues are candidates for tonsillectomies, or the surgical removal of the tonsils. In fact, this type of surgery is a lot more common than you may think. In children under age 15, more than 530,000 tonsillectomies are performed annually, making it one of the most common surgical procedures in the U.S.

“Tonsils are tissues that sit in the back of the throat and are part of your immune system,” says pediatric otolaryngologist Carissa Wentland, DO. “Their purpose is to filter out viruses, bacteria and allergens.”

However, if the tonsils become inflamed and infected by a bacteria or virus, the condition is called tonsillitis.

According to Dr. Wentland, there are two types of infections that can occur in the tonsils:

  1. Viral. “Most commonly, tonsillitis is going to be viral. Your child may have a sore throat, fever, painful swallowing and decreased appetite,” says Dr. Wentland. “The back of the throat will be very red.”
    Most cases of viral tonsillitis resolve in seven to 10 days and don't require antibiotics.
  2. Bacterial. “If it’s bacterial, such as strep throat, your child will have more severe symptoms,” Dr. Wentland says. “Look out for persistent high fevers (greater than 102 degrees F) and no improvement after three to four days. Large, tender lymph nodes in the neck and white patches on the tonsils can also be signs of strep throat. Associated symptoms such as runny nose and cough are more common in viral tonsillitis. If you are uncertain if the tonsillitis is bacterial or viral, you can visit a doctor for a throat swab or culture.”

Although tonsillitis is common among kids in the pre-school to teenage years, it doesn’t warrant the removal of the tonsils unless it’s a recurrent issue, Dr. Wentland says.

“One indication to get a child’s tonsils removed is recurrent strep throat," she says. "Specifically, it would need to occur seven times in one year, five times over two years or three times over three years. Other indications include recurrent throat abscesses or sleep disturbances due to obstruction from big tonsils.”

According to Dr. Wentland, children who don't have these numbers of infections will outgrow throat infections.

“The most common reason we take tonsils out is because of sleep disturbances due to obstruction from the tonsils and adenoids,” she says.

The three signs that may indicate your child’s tonsils are causing sleep difficulty are:

  1. Really loud snoring
  2. Sleep apnea – "They’ll have loud snoring with pauses in the breathing” says Dr. Wentland. “They may snort or gasp for air.”
  3. Large tonsil size

A sleep study may be conducted to diagnose sleep apnea if there is uncertainty about the diagnosis of obstructive sleep apnea or if your child has other medical indications for a sleep study.

If your child does have their tonsils removed, it’s a quick procedure lasting about 20 minutes with a one to two week recovery time.

“The child’s throat will be sore for at least a week,” says Dr. Wentland. “It’s good to have popsicles and soft foods on hand. Avoid anything sharp as it can scratch the back of the throat and lead to bleeding.”

In addition to taking precautions against sharp foods, your child will need to take it easy for approximately two weeks. While most kids return to school or daycare in a week, you should limit their activity for two weeks until they're fully recovered.

Carissa Wentland, DO is a pediatric otolaryngologist at University Hospitals Rainbow Babies & Children’s Hospital. You can request an appointment with Dr. Wentland or any other doctor online.

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