From the May 2018 issue

Is it Time for Tonsil Removal? How to Know

Do you suspect your child needs to have his tonsils removed? A Children's Hospital of Michigan expert offers advice for parents on when to get this surgery and why it's necessary.

Repeated bouts of strep throat each year, difficulty swallowing, snoring, enlarged or swollen tonsils.

Any of the above symptoms sound familiar? It may be time for your child to have his tonsils removed, explains Dr. Bianca Siegel, an ENT at Children’s Hospital of Michigan and an assistant professor of otolaryngology at Wayne State University in Detroit.

The tonsils serve as “one of the entry points for the immune system,” she says. “They do trap germs and have a function in terms of fighting infection.”

But they can also contribute to recurrent issues, such as enlarged tonsils that cause difficulty breathing or throat infections, she says.

Why have tonsils removed?

The tonsils are two bulges of tissue on either side of the back of the throat. Parents may be able to visually identify if they’re enlarged.

One of the more common reasons for tonsil removal is swollen tonsils, which can cause snoring, sleep apnea and difficulty breathing or swallowing. Parents may have a bit of difficulty identifying sleep apnea. Siegel advises parents to watch out for restless sleep and to keep an ear open for snoring, gasping and choking sounds while your child is sleeping.

Another reason for removal is if a child suffers from repeated throat infections such as tonsillitis or strep throat (typically five or six times over a year or three to four times per year over multiple years, Dr. Siegel says).

In these cases, a doctor may recommend tonsil removal, which is actually “very common” in children, she says – even more so than in adults.

What to expect

A tonsil removal surgery, also known as a tonsillectomy, is typically an outpatient procedure – unless the child is under the age of 3 or suffers from severe sleep apnea, in which case kids may be kept overnight for observation, Dr. Siegel explains.

During this procedure, doctors “almost always” remove the adenoids, a similar type of tissue located in the back of the nose, she says, since these become enlarged along with the tonsils.

Following the surgery, kids will experience a “pretty bad sore throat” and will be prescribed pain medication to help ease the pain.

Moms and dads, be aware: “One of the big things we see a problem with is dehydration,” Dr. Siegel says, due to the sore throat. It’s important for kids to be taking in fluids, so parents should encourage intake of fluids through juice, water or popsicles.

Kids who have had their tonsils removed can typically return to school within one week.

A new pediatric otolaryngology (ear, nose and throat) clinic is coming soon to the Children’s Hospital of Michigan Stilson Specialty Center in Clinton Township. For more information or to make an appointment with a pediatric specialist, visit childrensdmc.org or call 313-745-KIDS.

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