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July 25, 2024
Being a parent is not easy. Finding your way through different diseases that your little one is suffering from can be difficult, not to mention it can be daunting to see them suffer. Keeping infections at bay can feel like a major task as infections can bring about further complications.
One such complication is tonsilitis, a disease commonly caused by infection. It is more common in children than adults. Severe tonsillitis may require surgical removal through a procedure called tonsillectomy.
Today, we will deep dive into tonsillitis and tonsillectomy and understand certain important aspects associated with them.
We have two oval-shaped tissues like pads at the back of our throat, one on each side, known as tonsils. These are a part of the body’s immune system.
As they are located at the palate and throat, they stop germs in the body through the nose or mouth. When the tonsils get inflamed, then it is known as tonsillitis.
Tonsillitis commonly affects children between preschool and mid-teen years. The most common symptoms of tonsillitis include:
Very young children may not be able to describe how they feel. Look for the following signs:
If your child is facing any of the above issues, take your child to the paediatrician. Getting a thorough checkup is always a good idea.
In most cases, tonsillitis is caused by common viruses, but it can also be caused due to a bacterial infection.
Most commonly tonsillitis is caused by the bacterium Streptococcus pyogenes (group a streptococcus), the bacterium that causes sore throat. However, other bacteria can also be responsible for tonsillitis.
The tonsils are our immune system’s first line of defence against viruses and bacteria that enter our mouth. Due to their inherent function, tonsils are vulnerable to infection and inflammation. Tonsils play a major part in the immune system at a young age and their function starts to decline as a child crosses puberty. This is one of the reasons why tonsillitis is more common in children than in adults.
A tonsillectomy is a common surgery performed to remove the tonsils. Usually, children and teens experience this. During tonsillectomy, the tonsils are removed from the back of the throat.
Sometimes, a surgery named adenoidectomy is performed where the adenoids are removed. Also a part of the immune system, the adenoids are located at the end of the nasal passage of children. They help trap germs from entering our nose and mouth. Adenoids start to shrink around the age of 5 and usually disappear by the time someone becomes an adult.
Not all tonsillitis cases require tonsillectomy. Your child’s paediatrician may recommend a tonsillectomy if the tonsils are very swollen, get infected frequently or disturb your child’s sleep. Tonsils become red when they get swollen. Sometimes they can get so swollen that they meet and touch at the end of the throat. This can disturb your child’s breathing and can cause a lot of discomfort to your child. Your little one may find it difficult to breathe, especially at night. Sometimes they can get so severe that they can lead to sleep apnoea (a disease where breathing stops temporarily).
While sleep apnoea is serious for adults, it can be more difficult for children and even dangerous, especially if your child is an infant or a toddler. It can mess up your child’s sleep timing and in turn, can affect their daily life such as school or play. It can also lead to other serious side effects such as disturbing physical growth, and issues with heart or behaviour problems.
Another common reason your doctor might recommend tonsillectomy or adenoidectomy is if your child has been having frequent infections. Infections are considered repetitive if your child has seven or more such infections in a year.
Tonsils can lead to other problems such as:
Hence, doctors prefer to remove them altogether.
Tonsillectomy is a simple procedure which takes about half an hour to perform. Let’s understand the procedure of tonsillectomy surgery in detail.
Your healthcare provider may suggest certain things to prepare your child for the surgery. They may ask your child to stop medication for a week or two before the surgery. Your doctor may also advise you to stop giving your child food and drinks since the stomach must be empty during the procedure.
Emotionally speaking, this may be a daunting time for your child, even though the surgery is a small procedure. Hence, it’s important to prepare your child emotionally. Also, talk to them about what to expect from the surgery and assure them that there’s nothing to worry about.
Tonsillectomy is usually done by an ear, nose and throat (ENT) surgeon. The procedure is usually done under general anaesthesia. Hence, the ENT surgeon may be accompanied by an anaesthesiologist, who will keep your child comfortably asleep during the surgery. There will be no cuts through the skin as the surgery will be done through your child’s open mouth. Hence, there will not be any visible scars.
Tonsillitis surgery can be done in two ways:
After the surgery, your child will wake up in the recovery area. Some children are allowed to go home the same day, while some may need to stay overnight. Generally, children under three years of age or who have other issues such as sleep apnoea are kept overnight under medical supervision.
Recovery after a tonsillectomy may take a week or more, depending on the type of surgery done. Kids may experience some pain and discomfort after the tonsils are removed, especially in the first few days. Eating and drinking can be especially hard.
Your child may expect the following symptoms after the surgery:
As a parent, it is common to wonder if there are any risks associated with tonsillectomy. Well, all surgery entails some amount of risks and tonsillectomy is no exception. There’s always the risk of infection or issues with anaesthesia.
As children experience pain while swallowing, many children do not drink enough water after tonsillectomy. This can lead to dehydration. Keep a tab on how much water your child is having.
Also, keep a watch out for bleeding. A little bit of blood in the saliva is not uncommon. However, if your child throws up or coughs up or even spits out a significant amount of blood or blood clots then contact your doctor right away. You may also take your child to the hospital emergency.
If your child faces any of the following issues, you should also call your doctor:
Your child will need utmost care, especially for the first two weeks after the surgery. Give your child pain medication as per the directions of your doctor. The kid should rest at home for the first few days and have a lighter routine the first few weeks following the surgery. They can return to school after they can eat normally, have a good night’s sleep and don’t need pain medication.
The child will not be able to eat solid food for the first few days. Offer soft food such as soup, pudding, gelatine or mashed potatoes till the child can start solid food. Keep a note of the amount of water that your little one is having and keep a lookout for signs of dehydration.
The signs of dehydration include:
The removal of tonsils does not mean your child will not catch a cold or suffer from throat infections. However, tonsils rarely grow back hence getting tonsillitis is very rare.
Although the tonsils are a part of the body’s immune system, their removal does not affect the body’s ability to fight infections. The immune system has various ways to fight germs, so other processes will perform normally.
Tonsillectomy is not a complicated surgery. Millions of children undergo it every year. We know as a parent, any surgery that your child may go through, is a cause of worry for you.
But there’s nothing to worry about in the case of tonsillectomy. Your child will be up and running in no time.
Children may need tonsillectomy at any age. Children between the ages of 5 to 15 usually need this surgery. It’s important to note that all tonsillitis cases do not need tonsillectomy. The doctor evaluates the condition of a child and then decides whether tonsillectomy is required.
Your child will need special care, especially during the first two weeks after surgery. Follow your doctor’s instructions for giving pain medication. Your child should rest at home for the first few days and follow a lighter routine for the initial weeks. They can return to school once they can eat normally, have a good night’s sleep, and no longer need pain medication.
The indications that someone needs a tonsillectomy are:
– Very swollen tonsils
– Frequent tonsil infections
– Disturbed sleep due to sore throat
– Tonsils become red when they get swollen
– The two tonsils touch or meet when they are swollen
– Difficult breathing, especially at night
– Other severe issues such as sleep apnoea
Prof Dato’ Dr Abdullah Sani Mohamed
Consultant ENT, Head & Neck Surgeon (Visiting)
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