Tonsil and Adenoid Removal
Our practice regularly consults with families regarding tonsil removal and adenoid removal for children located in Melbourne and regional Victoria.
The primary treatment for children with obstructive sleep apnoea or sleep disordered breathing is surgical removal of the tonsils and adenoids. This is referred to as tonsillectomy and adenoidectomy or T&A surgery.
We know from our scientific data, that this operation will alleviate snoring, obstructive sleep apnoea and sleep disordered breathing in the large majority of children (approximately 90%).
In those where it does not rectify the problem, there is often something else affecting the airway – and this can be further investigated.
Why does tonsillectomy and adenoidectomy help sleep apnoea and snoring in children?
Tonsils, snoring and sleep apnoea
Tonsils and adenoid are lymphoid tissue at the back of the mouth and nose that help the body identify infections, and allergens in very early life. After this, they are relatively redundant and mostly cause problems with recurrent infections, and airway blockage.
If your child's tonsils are large in size or subject to recurrent tonsillitis / chronic tonsillitis or other infections, the tonsils can block breathing passages which results in difficulty breathing and sleep disturbance. In more severe cases, your child may temporarily stop breathing throughout the night, leading to obstructive sleep apnoea.
Adenoids, snoring and sleep apnoea
Adenoids are also tissues in the throat, located higher than the tonsils, behind the nose.
Enlarged adenoids can cause recurrent ear infections and nasal obstruction, potentially leading to snoring and OSA.
Tonsil and adenoid removal in kids
In children the tonsils and adenoids are typically removed at the same time to achieve the best outcome.
While in adults there can be many different causes of snoring (lifestyle, weight, stress, airway flow) in children the majority of snoring is due to:
- Large tonsils
- Large adenoids
- Large turbinates
- A combination of the above
We can discuss tonsil removal, adenoids and turbinates surgery for your child in detail during a consultation.
Frequently asked questions about Tonsil and Adenoid Removal in Kids
Yes. The operation is done under General Anaesthetic which means your child is completely asleep under the watchful eye of our skilled Anaesthetists for the duration of the operation.
Adenoidectomy and tonsillectomy in most cases, is minor and a routine procedure in children. It is one of the most common surgeries performed on children.
On the day of surgery, the operation itself takes around 30 mins. From the time you leave your child with us in the operating room until the time you can see your child in the recovery room, is approximately 1 hour.
The procedure involves a one-night stay in hospital (one parent or carer can stay the night)
There is no restriction on the amount your child can eat and drink after the operation although they will tend to want to stick to softer, colder things (ice cream, yoghurt, jelly, ice blocks, cool drinks) but if they feel like normal food… go for it! It’s best to avoid any foods with sharp edges such as chips as they can scrape the throat.
Getting the operation done is the easy bit – the recovery is the hard part…the ears and throat will be sore. Unfortunately it is a painful operation, but the kids generally do pretty well (nothing like the pain of tonsillectomy in adults). There is a small chance of bleeding afterwards and we will discuss what to do if this happens. It is normal for your child to have bad breath, sore throat or white patches on the side of the throat after the surgery. This will get better as the throat heals.
We will discuss pain medication and pain relief regime and what to expect at your consultation. Throat pain will be experienced for the first few days after the operation and is. Some children will experience a mild earache after a tonsillectomy. It is important to provide your child with regular pain relief during their recovery.
For the first 2 weeks after surgery, your child will need to be in care at home, off school/day-care with someone caring for them at all times. During this period we ask you to stay within 30 mins of a major hospital (with an emergency department) that has ENT Surgery cover.
If your child suffers from enlarged adenoids, they can block the eustachian tube which connects the ears to the nose and drains fluid from the middle ear. When fluid cannot drain from the ear, it tends to result in ongoing ear infections. That's one reason why adenoid removal surgery is carried out in combination with tonsillectomy.
There are risks involved with any surgical procedure although these are rare. Some potential risks of T&A include the risk of bleeding during or after surgery, dehydration, infection at the surgery site and difficulty breathing from swelling. There may be other risks depending on any other medical conditions your child may have. Please raise any concerns with our team before the procedure.
In the rare instances where Tonsillectomy and Adenoidectomy stops episodes of tonsillitis, ear infections and other symptoms but fails to fix the OSA/SDB, other causes must be considered. In addition to a sleep study, performing Drug Induced Sleep Endoscopy (DISE) can be incredibly useful.
Using DISE, if we can identify an area of collapse warranting treatment, we will discuss this with you at length and formulate a management plan. If you have any concerns regarding your little one(s) and obstructive sleep apnoea/sleep disordered breathing in children – please contact us to schedule an appointment.