What are Tonsils?
Tonsils are part of a “ring “of the glandular/lymphoid tissue encircling the back of the throat. Tonsils are visible at the back of the mouth, on each side.
What role do they play in our body system?
They act as “policeman” and help to form antibodies to fight germs that invade the nose, mouth and throat. This function are important in young children up to 3 years of age but there is no evidence that it will be important thereafter.
Will my child suffer a loss of immunity after the removal of my tonsils?
The tonsils are only a very small part of our immune system. There are other lymph nodes in the body that would act as defence mechanism. Many research studies have shown that children that have their tonsils/adenoids removed suffer no loss in their immunity to diseases.
Children who have their tonsils removed do not, on average, have any more illnesses than children who “keep” their tonsils. In fact, these children will get fewer illness like strep throat, after their tonsils are taken out.
The Examination
The primary methods used to examine tonsils are:
- Medical history
• Physical examination
• X-rays/Endoscopy
What should my child expect at the Examination?
The doctor will ask about the child’s problems and examine the ear, nose, throat, head and neck areas. He will use a small lighted instrument to look into these areas.
Tonsils are checked via nasal optic examination using a flexible endoscope (no pain) to evaluate the upper airway condition of children who are cooperative. This procedure is done in the clinic. The examination begins with an assessment of the nasal cavity and its structures up to the nasopharynx with a good view of the auditory tube and the oral cavity. Generally, the optic examination is painless and well tolerated by children. Recording is usually done so that it is possible to review the images.
X-ray would be used if the child is uncooperative with the nasal optic examination. This is helpful in determining the size and shape of the tonsils.
3 Common Causes of Tonsillitis:
Group A streptococcus – common bacteria that cause throat infections in 1 in 5 patients including adults. Some patients may not have any symptoms but they are still capable of transmitting the bacteria. Group A streptoccus may also cause strep throat.
Infectious mononucleosis – caused by the Epstein Barr virus, can also produce symptoms of tonsillitis, especially in young children
Respiratory viruses – especially cold and flu viruses, could results in tonsillitis. These are not as severe as bacterial infections but sometimes may be difficult to differentiate between a viral and a bacterial infection.
Symptoms and Complications of Tonsillitis
Usually pain/sore in the throat, but since the throat and ears share the same nerves, the pain may sometimes be felt in the ears. The pain is usually worse when swallowing. Very young children may not complain of a sore throat but may simply refuse to eat.
Other symptoms can include:
- Fever
- Sore throat
- Bad Breath
- Snoring
What problem does enlarged Tonsils caused?
Enlarged tonsils can cause snoring, obstructive sleep apnea, throat obstruction to breathing while they are sleeping. Obstructive sleep apnea is when a child briefly stops breathing while sleeping. It often occurs because of a blockage in the airway.
All About Tonsillectomy
When do you need a Tonsillectomy?
Tonsillectomy is recommended when the tonsils become a liability. They become a liability when they become infected (tonsilitis) or when they grow too large in size (tonsillar hypertrophy).
If the following symptoms is observed:
- recurrent bacterial tonsillitis
- breathing problems caused by swollen tonsils
- sleep apnea
- bleeding on tonsils
- tonsil cancer
Tonsillectomy would be an option to discuss with the doctor.
Will you outgrown your tonsils?
Some of you may be asking, if the tonsils are an important part of the immune system, why take them out? Most of the early education of your immune system occurs before age 6. Either during this time, or even long afterwards, if your tonsils are so large that they literally obstruct your breathing at night, then wouldn’t you think that this is a more important issue that needs to be dealt with?
Doctors will also say that children will “grow out of it.” Yes, in most cases, they will, but based on all the recent studies, there’s plenty of evidence that before they “grow out of it,” there can be potential long-term consequences, including their risk for developing obstructive sleep apnea, heart disease, heart attack and stroke later in life.
How do you prepare for a Tonsillectomy?
Your child needs to fast 6 hours prior to the surgery. No food/drinks/water is allowed. For a younger child, there will be a shorter fasting period.
If the child has fever on the day prior to the surgery date, the doctor should be informed as the surgery might be postponed if the child is found unfit for surgery.
It should also be brought to the doctor’s attention if the child has any history or family history of bleeding disorder or has any problem with previous anaesthetic event.
About The Surgery
How is the surgery done?
The surgery is done under general anaesthesia and this procedure is usually done as a day procedure. There is no need to stay overnight in the hospital.
This surgery usually takes between 35 to 45 minutes and it is done through the oral cavity (mouth) and the is no incision will be made on the face.
What are the latest techniques for removing the tonsils (no pain method)?
Specialised instruments such as coblation and microdebrider are used to improve healing and reduce the side effect of pain after surgery.
How painful is a tonsillectomy?
The level of pain is no more than a tonsilitis attack. With the use of specialised surgical instruments and good painkiller medications, the level of pain is very manageable.
Recovery After a Tonsillectomy
What to expect right after the surgery?
After the surgery, the child might be still sleepy as he/she is still recovering from the general
anesthesia but this effect will wear off after a period of time. After which, he will be allowed to drink and eat. Soft diet is recommended during recovery and ice cream and cooled drinks are encouraged after surgery.
Should there be a slight presence of blood in the child’s sputum, this is normal.
What are the things to take note after the surgery?
Few days after the surgery, the child may experience sore throat and dryness of the mouth but it will slowly improve when the throat muscles are back to normal. Normal eating habits should be resumed and this is greatly encouraged to prevent debris from accumulating and will also aids in the recovery process. Pain killer that has been prescribed to the child must be taken to minimize any throat discomfort and the entire course of antibiotics should be completed.
There may be a whitish coating at the back of the throat at the tonsillar beds during the first few days of recovery, this is a normal phenomenon of a healing wound in throat.
Is there any follow up with the doctor post surgery?
Post surgery follow-up date will be given upon discharge from the hospital. Please do come for the appointment as the post surgery follow-up care is important in preventing possible complications.
Frequently Asked Questions
Is it common for children to get a tonsillectomy?
Tonsillectomy is a long-practiced procedure that is still considered as one of the most common surgeries for children.
Children tend to have large tonsils, but in some cases, they may lead to breathing difficulties. If you notice recurring symptoms in your child, it is best to consult an ENT specialist.
How painful is a tonsillectomy?
The level of pain is no more than a tonsilitis attack. With the use of specialised surgical instruments and good painkiller medications, the level of pain is very manageable.
Is there any diet restrictions after the surgery?
No, there is no diet restriction post surgery and normal diet is greatly encouraged. After tonsillectomy, the child is usually put on soft diet for a day or two and must keep hydrated. Cold milk and drinks would help to soothe the throat.
Can the patient talk after tonsillectomy?
You can talk as per normal after the surgery. Keep your throat hydrated.
Is there anything the patient should avoid post surgery?
During the first week post surgery, it is encouraged that the patient should avoid contact with people suffering from coughs, colds or other infections. Contact with smoking individuals and crowded places are also not be encouraged.
Is it common for children to get a tonsillectomy?
Tonsillectomy is a long-practiced procedure that is still considered as one of the most common surgeries for children.
Children tend to have large tonsils, but in some cases, they may lead to breathing difficulties. If you notice recurring symptoms in your child, it is best to consult an ENT specialist.
How painful is a tonsillectomy?
The level of pain is no more than a tonsilitis attack. With the use of specialised surgical instruments and good painkiller medications, the level of pain is very manageable.
Is there any diet restrictions after the surgery?
No, there is no diet restriction post surgery and normal diet is greatly encouraged. After tonsillectomy, the child is usually put on soft diet for a day or two and must keep hydrated. Cold milk and drinks would help to soothe the throat.
Can the patient talk after tonsillectomy?
You can talk as per normal after the surgery. Keep your throat hydrated.
Is there anything the patient should avoid post surgery?
During the first week post surgery, it is encouraged that the patient should avoid contact with people suffering from coughs, colds or other infections. Contact with smoking individuals and crowded places are also not be encouraged.
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