Scheduling tonsils to be removed figures into many parents' itineraries for their childrens' summer vacation, right up there with summer camp stays and family reunions. An estimated 500,000 children have the procedure each year. "Kids need from ten days to two weeks recovery time, so summer offers an ideal opportunity to get tonsil removal out of the way without interfering with school or winter holidays," said Dr. Laura Cozzi, otolaryngologist, Gottlieb Memorial Hospital, part of Loyola University Health System (LUHS). Dr. Cozzi sees a jump in her surgeries at the Gottlieb campus beginning in June and settling back down in August.
"Improving breathing, eliminating snoring and reducing colds and ear infections are usually the reasons for having tonsils removed - usually nothing life threatening or urgent so the surgery can be arranged when it is most convenient," said Dr. Cozzi.
Sleep disturbances are the most common reason for tonsillectomies in children, as well as in adults. "Enlarged tonsils and adenoids prevent proper air flow, leading to frequent waking during sleep and also loud snoring," said Dr. Cozzi. "This lack of healthful sleep can cause irritability, poor performance in school and even in very rare cases, developmental delays." The rate of tonsillectomies among girls is twice that of boys, while rates of adenoidectomy is about 1.5 times as high in boys as girls.
The most common age for tonsil removal is between three and seven. "Tonsils usually shrink between the ages of seven and eight, if they don't, many parents of these school-age children want them removed to prevent existing or recurring health problems," she said.
Tonsils are lymph tissue in the throat that help fight infections. People actually have three sets of tonsils; the set of tonsils visible in the back of the throat are removed as well as the adenoids, which are also located in the back of the nose and are not visible. "Tonsils and adenoids become enlarged due to chronic infections," explained Dr. Cozzi. "Tonsils are graded in size from 1 to 4, with the largest commonly called 'kissing tonsils' because they are so large they bump each other." The larger tonsils often produce a "husky" sounding voice and children, in addition to snoring, may have trouble swallowing certain foods.
The tonsils are removed with a scalpel, a heated instrument or a coblator, in an outpatient surgery. "Many parents remember staying in a hospital overnight as children after having tonsils removed but, today, the surgery takes about one hour and children go home to continue their recovery, which is less traumatic and preferred by parents and young patients," said Dr. Cozzi. A tonsillectomy is the most common major surgery in children.
Here are tips from Dr. Cozzi that your child may need to have tonsils and/or adenoids removed:
•Your child regularly breathes through his or her mouth
•Loud snoring, movement, repeated awakening during sleep
•Recurring ear infections or sore throats which often lead to greater likelihood of susceptibility to other illnesses
•Persistent runny nose, cough or other sign of a cold.
• Debris often trapped or caught in tonsil pockets, creating "white spots" or foul odor
•Visibly large tonsils
"While eating lots of ice cream is often cited by parents to their children as an encouragement to having the surgery, it is really more important that lots of liquids be consumed, to avoid dehydration," said Dr. Cozzi. "But my patients like the idea that they can watch TV, play video games and surf the net more than usual, during their recovery."
Loyola University Health System