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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