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Tonsillectomy - child

Before you agree to your child having a tonsillectomy it is important to know all you can about this form of treatment for tonsillitis. The information here is a guide to common medical practice. Each hospital and doctor will have slightly different ways of doing things, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your tonsillectomy treatment choices with your doctors. You should mention any worries you have. Remember that you can ask for more information at any time.

 

 

What is the problem?

Your child is probably having repeated tonsil infections, called acute tonsillitis. It is usually better to remove your child’s tonsils than for your child to suffer repeated tonsillitis. The removal of the tonsils is called a tonsillectomy.

 

Antibiotics are good for treating each attack of tonsillitis but will not prevent future attacks. If we remove their tonsils they will not have acute tonsillitis again.

Tonsillectomy - child

What are the tonsils?

You can see your tonsils inside your mouth at the back of your throat. There is one on each side of your tongue behind your back teeth.

 

Tonsils are made of lymphoid tissue, which helps the body fight infection. If you get a throat infection, the tonsils become swollen to fight the infection. When the infection has gone, they get smaller again. There are other areas in the head and neck and all over the body made of lymphoid tissue, so without the tonsils the body can still fight infections.

 

What has gone wrong?

After a lot of repeated attacks of tonsillitis, the tonsils become scarred and remain enlarged. They may even keep infection trapped inside. In this state, the tonsils are no longer good at fighting infection and are best removed. More tonsillitis may cause an abscess to form underneath one of the tonsils. This is called a quinsy and can be very painful.

 

The aims

The aim of a tonsillectomy operation is to completely remove both tonsils. This leaves two shallow troughs were the tonsils have come out. Your child will have a general anaesthetic and be unconscious for the operation.

Tonsillectomy - adult 2

The benefits

Without tonsils your child cannot get acute tonsillitis again. They may still get mild sore throats due to the viruses that result in colds, coughs or the flu but these will not last very long.

 

Are there any alternatives?

There are no tablets or medicines that will permanently stop children getting tonsillitis. Antibiotics can make the tonsillitis better but if the tonsils are frequently infected, antibiotics may not work well. The only way to stop your child having repeated attacks of acute tonsillitis is to remove the tonsils.

 

What if you do nothing?

Your child may continue to have tonsillitis. Your doctor can prescribe antibiotics to make the sore throat go away. This may take more than one course of medicine.

 

Who should have it done?

Your child should have their tonsils removed if they are:

 

  • having five or six attacks of acute tonsillitis each year
  • very ill with each attack
  • off school a lot.

 

Who should not have it done?

Children who have other medical conditions that would make it unsafe for them to have a general anaesthetic should not have one. There are also specific medical situations when a tonsillectomy should not be done and these are:

 

  • when your child is on medication that prevents their blood from clotting, such as Warfarin
  • when your child has an illness that prevents their blood from clotting, such as haemophilia.

 

Both these situations would lead to more bleeding than normal. If you think either of these applies to your child, inform your doctor. They will take a blood sample to test the clotting of their blood.

 

Author: Mr Robert Ruckley MB. ChB.  F.R.C.S.  Consultant ENT surgeon.

© Dumas Ltd 2006

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