Tonsillectomy is the surgical removal of the tonsils, sometimes together with the adenoids, which is called adenotonsillectomy. The decision to proceed with surgery is not made on tonsil size alone. It depends on why surgery is being considered, the pattern and severity of symptoms, how much they are affecting the child, the examination findings and any treatment already tried where relevant.
Tonsils are lumps of tissue located on either side of the back of the throat. Along with the adenoids, which sit at the very back of the nose, they form part of the immune system's first line of defence. They essentially act as "goalies" that trap germs entering through the mouth and nose.
While they are designed to fight infection, they can sometimes become the problem rather than the solution. When tonsils become overwhelmed by frequent infections, they can enlarge permanently or become a reservoir for bacteria. This leads to a cycle of recurring illness that can significantly impact a child's quality of life.
The adenoids often shrink and disappear by adolescence. However, in young children, enlarged adenoids can block the back of the nose. This causes nasal obstruction, snoring, and can contribute to glue ear by blocking the Eustachian tube.
Tonsillectomy is most commonly performed in children for two reasons: recurrent or severe tonsillitis, and obstructive sleep apnoea or significant sleep-disordered breathing related to enlarged tonsils and adenoids.
Tonsillectomy is performed under general anaesthesia. Dr Crawford removes the tonsil tissue through the mouth, so there are no external cuts or scars on the neck. If the adenoids are also enlarged and contributing to symptoms, they may be removed at the same time.
The hospital and length of admission depend on the operation being performed, the child's age, medical history and individual circumstances. Some children go home the same day, while others are kept in overnight for observation.
A specialist anaesthetist manages the anaesthetic and cares for the child throughout the procedure. If a child becomes unwell before a planned operation, particularly with a respiratory infection, Dr Crawford and the anaesthetist may recommend postponing surgery, because respiratory infections can increase the risks of general anaesthesia in children.
Tonsillectomy is a common operation in children, but recovery can be painful and postoperative bleeding is an important risk. Bleeding after tonsillectomy is uncommon, but any fresh bleeding from the mouth or throat after surgery needs urgent medical assessment.
Dr Crawford discusses the expected benefits and risks carefully with the family before recommending surgery, including the risks associated with general anaesthesia.
Children undergoing tonsillectomy generally need around two weeks away from school or childcare. Pain often fluctuates during recovery and can become worse several days after surgery before it improves. Follow the pain-relief plan provided by Dr Crawford and the hospital.
Full detail on caring for a child at home after surgery, including warning signs, is covered on the post-surgery care page.
Dr Crawford consults at two locations across Sydney.
Dr Crawford sees children with common paediatric ENT problems at Sydney ENT Clinic in Darlinghurst and Kogarah. If your child has previous hearing tests, sleep studies or specialist letters, please provide these before the appointment where possible. A valid referral from your GP or another medical specialist is required to claim Medicare rebates.
Our team can assist with appointment enquiries and help arrange a consultation with Dr Julia Crawford at one of her three Sydney consulting locations:
Dr Julia Crawford consults for head and neck conditions, head and neck cancer, thyroid and salivary gland disease, obstructive sleep apnoea, paediatric ENT and selected general ENT problems.
Her team can assist with arranging an appointment at Darlinghurst, Kogarah or Chris O'Brien Lifehouse, and will help ensure the appropriate information and investigations are available before your consultation.