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Tonsils and Tonsillectomies

Everybody's heard of tonsils. But not everyone knows what tonsils do in the body or why they may need to be removed. Knowing the facts can help alleviate the fears of both parents and children facing a tonsillectomy.

What Are Tonsils?
Tonsils are glandular tissue located on both sides of the throat. The tonsils trap bacteria and viruses entering through the throat and produce antibodies to help fight infections. You can usually see the tonsils by looking in your child's throat using a flashlight.

Tonsillitis occurs when tonsils become infected and swell. If your child has persistent or recurring tonsillitis, your child's doctor may suggest that they be removed. Children do not suffer from more infections without their tonsils - other tissues in the body function the same as tonsils do, producing sufficient antibodies to fight infection.

What Are the Symptoms of Tonsillitis?
There are several symptoms associated with tonsillitis. Your child may experience:

sore throat
pain or discomfort when swallowing
fever
raspy voice
swollen glands (lymph nodes) in the neck

If you look down your child's throat, you may see red and swollen tonsils or a white or yellow coating on the tonsils. But don't rely on your own guesses when it comes to your child's health. You may not be able to judge whether your child's tonsils are infected. If you suspect tonsillitis, see your child's doctor.

Treatment of Tonsillitis
Because of success with antibiotics, surgery is no longer the standard treatment for tonsillitis that it was years ago. For many children, enlarged or swollen tonsils are normal. But recurrent sore throats and infections should be evaluated by a doctor. Your child's doctor may order a throat culture to check for strep throat. Strep are bacteria that cause infections. Bacterial infections respond well to antibiotics.

Left alone, your child's enlarged tonsils may eventually shrink on their own. Your child's doctor may suggest a tonsillectomy if one or more of the following conditions are present:

swollen tonsils make it hard for your child to breath
your child has difficulty swallowing
recurrent sore throats
recurrent throat infections
obstructive sleep apnea (a condition in which your child may stop breathing for a few seconds at a time during sleep because enlarged tonsils are partially blocking his airway)
What Happens During a Tonsillectomy?
Surgery, no matter how common or simple the procedure, is often frightening for both child and parent. You can help prepare your child for surgery by talking about what to expect. During the tonsillectomy:

your child will receive general anesthesia. This means the surgery will be performed in an operating room so that an anesthesiologist can monitor your child.
your child will be asleep for about 20 minutes.
the surgeon can get to the tonsils through your child's open mouth. There is no need to cut the skin.
the surgeon removes the tonsils with a series of incisions and then cauterizes (seals) the blood vessels.

Your child will wake up in the recovery area. Children that have trouble breathing or show signs of bleeding will return immediately to the operating room. In most cases, the total time in the hospital is 5 to 10 hours. Children under 3 years of age and children with chronic disease, such as seizure disorders or cerebral palsy, will usually stay overnight for observation.

Updated and reviewed by: Kim Rutherford, MD
Date reviewed: June 2001
Originally reviewed by: Steve Dowshen, MD

My tonsils were removed for me when I was five. I cooperated fully, as I was told I could have ALL the ice cream I wanted after they were out! Yippee!

My ex-wife, on the other hand did not have hers out, and still suffered from strep as an adult. I felt sorry for her. So I guess it has to be decided on a case by case basis.