Tonsillectomy in Children

Yeditepe University Kozyatağı Hospital Ear, Nose, and Throat Specialist Prof. Dr. Müzeyyen Doğan answered the questions about adenoids and tonsil problems in children. 

How to Treat Tonsil Infections in Children?

For the treatment of tonsil infection in children, we need to know about the possible causative agent. Here, quick antigen tests and blood count results help us. A throat culture should also be performed if the patient has a history of recurrent throat infection and/or a patient with a beta virus in the vicinity. Especially in young children, antipyretics are given to control fever if it is high. The causative virus, on the other hand, includes recommendations for symptoms such as using drugs to decrease the patient's fever and pain and having them rest. If the active substance is beta, antibiotics are started, and antibiotic treatment is continued for 3 more days after the fever decreases. The throat culture is repeated 3 days after the antibiotic treatment is completed. It is particularly important to remove this microbe from the body, especially in childhood. In some patients, the beta microbe, which can settle in the heart valves and kidneys, also leads to a type ofrheumatism.

Which Conditions Require Surgery?

• Surgical indications can be grouped under the following headings.
• Frequent tonsil infection: Having had a feverish throat infection 4-5 times in the last year
• Unilateral growth of tonsil tissue (Unilateral growth suggests some malignant diseases such as lymphoma)
• Tonsils reaching dimensions that may cause occlusive effects.
• Failure to remove group A beta-hemolytic streptococcus microbe from tonsils despite drug treatment

How to Perform Tonsil Surgery in Children? Can the Adenoid Be Removed at the Same Time If Necessary? What Anesthesia is Used? How Long Does the Surgery Take?

Pediatric tonsil surgeries are performed under general anesthesia. In adults, gag reflexes can also be performed with local anesthesia in appropriate patients with not much gag reflex. If it is necessary for the same operation in children, the adenoid may also be removed. The duration of tonsillectomy varies from 30 minutes to 1 hour depending on the technique used. The main application is to separate the tonsil tissue from the surrounding muscle tissue. This can be done using a surgical instrument such as scissors and forceps. Today, techniques to reduce bleeding have been developed, including thermal welding, radiofrequency, and Coblator (Plasmar). The differences in these techniques are due to the different energy used to separate the tissue. The thermal welding technique uses heat to separate tissues, while the radio-frequency uses sound waves and the Coblator uses plasma.

Is Tonsil Surgery in Children Painful?

Postoperatively, the area where the tonsils are located remains an open wound. The contact with food and beverages here leads to pain. The pain gets better as the tissue gets better. Wound healing is quick in children.

What can be done to reduce pain?
Pain relievers are routinely used in the first days after surgery. In the following days, we want it to be given when there is pain. Cold drinks and ice cream have a pain-reducing effect in the postoperative period.
How Long Does It Take For the Child to Recover?
It is possible to remove the tonsils of the child without traumatizing the surrounding muscle tissue since they protect the capsule structure. Recovery in children is usually complete after 1 week-10 days. The area where the tonsils are removed is covered with white-colored tissue in the first days. This is not inflammatory tissue. It then replaces it with a pink-colored tissue that resembles the tissue in the oral mucosa and healing is complete.