Before my daughter turned one year old, she already had a couple of bouts with tonsillitis. While she responded to antibiotics with majority of those bouts, there were still other instances when she had to be hospitalized because she had very high fever along with a very poor appetite. In the beginning, I was hoping that my daughter would no longer deal with recurrent tonsillitis as she got older, but when she turned two years old, I realized that those episodes of tonsillitis were not going away on its own. Despite antibiotic therapy, her tonsils remained enlarged, and I also noticed that she seemed to snore more loudly, and her breathing became somewhat labored during sleep. After seeing a doctor, I was faced with grim news. My daughter needed a tonsillectomy.

What is a tonsillectomy?

A tonsillectomy is the surgical removal of the tonsils. The procedure is done under general anesthesia, but no incision is required because the tonsils can be removed through a patient’s open mouth. The operation will only take 20 to 30 minutes, and the doctor may only require the patient to stay in the hospital for a couple of hours or more for monitoring.

What is the difference between a traditional tonsillectomy as compared to an intracapsular tonsillectomy?

In traditional tonsillectomy, the tonsils are completely removed while during an intracapsular tonsillectomy, a small layer of tonsil tissue is left to serve as a protection for the throat muscles. With this technique, recovery is quicker, and the discomfort is also lesser as compared to the traditional method. The risk of post-operative bleeding or hemorrhage is also significantly reduced. However, there is still a 1% chance that the residual tonsil will enlarge or become infected.

Why is it indicated?

Doctors would usually order a tonsillectomy if a child presents with any of these symptoms:

– Recurrent tonsillitis of at least 5 episodes per year, or even 3 to 4 episodes per year for

several years in a row.

– Tonsillitis that lasts more than 3 months

– Inflamed tonsils that causes breathing obstruction such as sleep apnea, or a pattern of

breathing characterized by breathing pauses that may last from seconds to even minutes

– Swallowing difficulty

What needs to be done prior to the surgery?

Prior to the date of the operation, your child’s doctor will perform a physical exam, and he will definitely order blood tests. Provide the doctor with your child’s thorough medical history, and include any drugs or even herbal remedies that your child is currently taking. Do not give any medications that contain Aspirin, Ibuprofen, Naproxen, and Warfarin 10 days prior to your child’s surgery because these can interfere with normal blood clotting. During the day of the surgery, your child is not allowed to eat or drink water hours before the operation. A small sip of water is allowed only when there are medications that need to be taken prior to the surgery.

What are the risk factors?

The risk of bleeding and infection is always present following any surgical procedure. Inform your doctor right away if you notice that your child is swallowing more frequently because it is a sign of bleeding. Any sign of active bleeding should also be duly reported.

How long does the recovery take?

The surgical technique can greatly affect the length of recovery. Typically, a child may feel some ear and throat discomfort for a week or two after the surgery. Bad breath and fever of 102 degrees Fahrenheit is also expected during the recovery period. However, as early as two weeks after the surgery, your child may already resume his normal activities.

What to do after the surgery?

Try to get your child to avoid crowds or sick people while he is recuperating. Hydration is also important, so encourage your child to drink more fluids. Cool drinks are ideal during this period because it can reduce swelling and relieve the discomfort.  Pain medication may be taken as per doctor’s order.

What is the prognosis/outcome?

Tonsils are known as the body’s first line of defense because they keep viruses and bacteria from getting farther down the throat. However, removing them will not put a child at risk for more infections because other defense mechanisms of the body will compensate. In fact, studies show that children get fewer throat infections after having their tonsils removed.

Although a tonsillectomy may be a common procedure for doctors, I feel that this last recourse may have to wait when it comes to the treatment of my daughter. With plenty of identified food and drug allergies, I am not prepared to take the risk yet. Do you have a child who underwent a tonsillectomy? Did his quality of life greatly improve after the procedure?