Tonsillectomy is one of the oldest and most commonly performed surgical procedures in both children and adults. But when do the tonsils actually need to be removed? We spoke with Dr. Sofia Stamataki, Director of the ENT Department at Euroclinic Children’s Hospital, who answered some of the most common questions parents have.
What Are the Tonsils and What Is Their Function?
The tonsils, more specifically the palatine tonsils, are lymphatic tissues located at the back of the mouth, one on each side. They are part of the immune system and play a defensive role against inhaled viruses and bacteria.
When Is Tonsil Removal Recommended?
The term tonsillectomy refers to the surgical removal of the palatine tonsils. The indications for tonsillectomy have generally remained the same over the years and include:
Do the Tonsils Need to Be Completely Removed?
In some cases, tonsil surgery can be performed in a more conservative manner. When enlarged tonsils are the main issue, an intracapsular tonsillectomy may be performed.
In this procedure, the enlarged tissue causing the obstruction is removed, while the tonsillar capsule and a small amount of tonsil tissue are preserved. As a result, recovery is generally much easier for the child, with significantly reduced postoperative pain and a lower risk of postoperative bleeding. However, there is a small possibility that the remaining tissue may regrow — reported in the literature at approximately 2% — and cause symptoms again. Together with your pediatric ENT specialist, you can discuss the available options, indications, and contraindications in order to make the most appropriate decision regarding tonsil surgery.
Will My Child Get Sick More Often After Tonsil Removal?
This is a very common concern among parents, who worry that removing the tonsils may weaken their child’s immune system. However, numerous reliable international studies have shown that tonsil removal does not impair the body’s immune defense against bacteria and viruses. The human body has multiple defense mechanisms against infections. In fact, after surgery, children often experience fewer sore throats and throat infections.
What Are the Different Tonsillectomy Techniques?
As medical technology has advanced, tonsillectomy techniques have also evolved.
Various methods are currently used, including bipolar diathermy, coblation, microdebrider (debrider), laser, and the older cold steel technique (scissors). All techniques aim to minimize bleeding — both during and after surgery — as well as postoperative pain. However, no technique has completely eliminated these potential complications. Together with your doctor, you can discuss the available surgical methods and learn about the advantages and disadvantages of each one.
What Is the Surgical Procedure Like?
For most children, tonsillectomy is performed as a day surgery procedure. This means that children are admitted on the same day for preoperative evaluation and surgery, with every effort made to minimize stress for both parents and children. The procedure is always explained to the children beforehand, and it is helpful for parents to prepare them in advance as well. Anesthesia is usually administered in the presence of the parents. The surgery, including recovery from anesthesia, takes approximately 45 minutes on average. After the operation, children remain in the hospital for a few hours until they are fully awake and able to start drinking and eating.
What Is Recovery Like at Home?
After tonsillectomy, children usually stay at home and avoid school and other activities for approximately one week. During this period, instructions are given regarding regular pain relief medication, soft and lukewarm foods, and of course ice cream — a favorite among children! Possible complications are rare and mainly include bleeding and dehydration due to insufficient fluid intake. Your doctor will provide clear instructions to help prevent these complications. In any case of concern, parents should be able to contact their doctor directly. With proper care, recovery is generally smooth, and children can soon return to their normal daily activities.
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