Something has changed about getting your tonsils out

Something has changed about getting your tonsils out

If your tonsils have been removed, you’re not alone. Tonsillectomies are one of the most commonly performed surgeries on American children – about 289,000 were performed on kids under age 15 in 2017.

“Children may need this procedure because they suffer from obstructive sleep-disordered breathing, obstructive sleep apnea or recurrent throat infections,” says Dr. David Walner, director of Pediatric Otolaryngology at Advocate Children’s Hospital in Park Ridge, Ill.

Changes are coming to recovery from the popular procedure. The American Academy of Otolaryngology updated its guidelines just last month.

One major change? How pain is managed after surgery. The typical recovery time for this procedure is 10 to 14 days. Some children experience little to no pain after surgery and have an easy recovery process, while others experience significant pain. While a child’s pain obviously needs to be managed, the new guidelines specify that clinicians should not administer or prescribe codeine to children under the age of 12 who undergo a tonsillectomy.

Instead, Dr. Walner says the guidelines indicate that clinicians should explore other pain management options such as ibuprofen and acetaminophen with patients and their families.

“These new guidelines stress the importance of perioperative pain counseling to find the best pain management options for the patient,” says Dr. Walner, who was one of twelve physicians involved in updating the guidelines.

Additionally, the updated guidelines emphasize a watchful waiting approach rather than surgery for recurrent acute tonsillitis until children meet the criteria for the surgical procedure. For example, a child who has seven infections in one year or nine or ten infections in two or three years should be evaluated for potential surgery.

“Many kids do benefit from surgery due to suffering from recurrent infections, but they need to meet the criteria and have enough frequent infections to warrant the procedure,” says Dr. Walner, who has performed more than 2,000 tonsillectomies over the last 20 years. “We don’t want to put children through surgery unless we know it’s going to improve their quality of life. The wait-and-see approach is something clinicians should discuss with parents before children undergo surgery.”

The updates to the guidelines allow for a dialogue between physicians and parents to determine the best treatment options for their child.

“These modifications were made to improve the quality of care for children undergoing tonsillectomies,” says Dr. Walner.

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  1. The implicit assumption is that a good measure of today’s children SHOULD have this surgical procedure…I highly question that. Moreover: One has to say that God put tonsils in for a reason…to HELP clear out infections!

    Having a child in pain, though, is no picnic. My father (even in the 60s well versed in naturopathic and natural remedies) used an age old liquid I believe can STILL be had at a pharmacy! It’s called Argerol. It’s a liquid one then sprays over the tonsils and top side of the mouth. It soothes and helps draw out the inflamation in such flareup.

    I, myself, remember at least one time my Dad used this on me. AND BOTH I AND MY OTHER TWO SIBLINGS – 50+ YEARS LATER – ALL STILL HAVE OUR ORIGINAL TONSILS!

    There are still times, I’m sure, that surgery WILL be required. But quickly trying other treatments should surely be the first course of the day! My personal opinion…

  2. I see no assumption in this article that most kids should get them out. The criteria stated is recurrent infection and also obstructive sleep apnea.

    My daughter had both tonsils and adenoids out in third grade. Before that, she had horrible sleep apnea and snoring from them – we could hear her three rooms away with doors closed. As a result she was always tired, mornings were awful because getting her up was really rough. She had trouble paying attention in class because she was so tired. She also tended to get sick often, probably due to lack of sleep and the restorative properties of sleep. She was cranky most of the time and just overall not a happy child. She was honestly just exhausted.
    Once she got the tonsils and adenoids removed, the difference in her was amazing. She slept well and rarely got sick. She was eager to get up in the mornings for school. Her grades improved tremendously. Her teachers no longer thought she had attention issues. She ended up graduating in the top 10% of her class and was offered academic scholarships. Most of all she was happy kid.

    If tonsils are causing sleep apnea, taking them out can make a tremendous difference in the quality of the child’s life. Sleep os a pretty crucial thing for all of us.

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health enews Staff
health enews Staff

health enews staff is a group of experienced writers from our Advocate Health Care and Aurora Health Care sites, which also includes freelance or intern writers.