Children's ENT Throat & Voice
Tonsillectomy: What Parents Should Know For Their Child
February 3, 2020
Tonsillitis (tonsil infection) is a common reason why many parents bring their children to see an ENT Specialist in Singapore. Symptoms typically include difficulty in swallowing, severe sore throat, a scratchy voice and fever that typically last for more than 5 days.
Our tonsils help support the immune system by trapping viruses and bacteria as you swallow or breathe. This prevents them from entering the body through the nose and mouth and cause infections. The size of tonsils changes over time, and children are more susceptible to tonsillitis when the tonsils grew too large.
What is tonsillectomy?
It is the surgical removal of the tonsils. Tonsils are two oval-shaped lumps of soft tissue located at the back part of the throat. The decision to undergo tonsillectomy should not be taken lightly as with all surgical procedures, there are risks involved. Sometimes, these tonsil troubles are treatable and can be outgrown when the child is older.
Why would one need a tonsillectomy?
There are usually two reasons why kids have a tonsillectomy.
- Their tonsils grew larger that they block the airways and make it difficult to breathe
- They frequently get a lot of tonsil infections (tonsillitis)
Obstruction of airways
Due to gravity, the tonsils are brought down onto the airway, making it hard to breathe, especially during sleep. Breathing can also be stopped for short periods while asleep. This is known as obstructive sleep apnea (OSA), a serious condition that can lead to behavioural and health problems in children. Parents should listen for snoring and pauses in breathing – keep an ear out for choking noises followed by silence. OSA can make kids miss out on restful sleep and this can affect their learning, growth, and health. You should consult an ENT Specialist if your child exhibits some of the signs or symptoms suggestive of OSA.
Recurrent tonsil infections can severely affect children with symptoms like fever, strep, enlarged lymph nodes. How frequent is the recurrence? If they occur more than 7 times in a year, 5 times in 2 years consecutively, and 3 times a year for the past 3 years. Your doctor may recommend in removing the tonsils to reduce the frequency and severity of getting tonsil infections.
The effects and risks of a tonsillectomy
Like any other medical procedure, there are some side effects and risks.
For starters, there is a risk of bleeding after the surgery that can be a cause of worry and discomfort for both child and parents. Also, children can suffer dehydration since they tend to reduce fluid intake significantly during the recovery period.
Apart from the pain and discomfort during the post-surgery recovery period, you can expect a significant reduction in the frequency of infections. A parent’s support during the first few weeks after surgery is vital – give plenty of fluids, and soft, comforting foods such as pudding and ice cream that can be soothing.
Many studies have shown that surgical removal of the tonsils does not reduce one’s immunity. A Dannish study published in 2018 showed an association between tonsillectomy in children (less than 9 years old) and the risk of higher lung infections in the future. However, this study does not prove that tonsillectomy and adenoidectomy caused a higher rate of lung infections in children.
Most medical experts have also observed that as the child is older the size of tonsils and the frequency of tonsil infections can also reduce. However, if your child’s tonsil is causing significant problems such as frequent tonsil infections which significantly impairs his or her quality of life or has signs or symptoms of obstructive sleep apnoea, you may consider this surgical procedure. Talk it over to an ENT specialist and weigh the benefits and risks carefully before making a decision on tonsillectomy.
Medically reviewed by Dr Gan Eng Cern