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Tonsillitis: Should My Child Have a Tonsillectomy?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Tonsillitis: Should My Child Have a Tonsillectomy?
Get the facts
Your options
- Schedule a tonsillectomy for your child.
- Treat tonsillitis with medicines and home treatment.
Key points to remember
- Tonsillectomy may be no better than taking a wait-and-see approach for children who have only a few throat infections a year.
- Your child may benefit from surgery if he or she is missing a lot of school because of repeated throat infections or has trouble sleeping because of enlarged tonsils that may block his or her airway. Talk with your doctor about the possible benefits of surgery for your child as well as the costs and risks of the procedure.
- Tonsillectomy may reduce how often your child gets throat infections. But even without surgery, tonsillitis will probably occur less often as your child gets older.
- For some children, tonsillectomy can greatly improve quality of life. Enlarged tonsils can block your child's upper airway and cause snoring, a stuffy nose, and breathing problems. Surgery can help relieve these problems.
- Doctors don't all agree on how many throat infections in a year point to the need for tonsillectomy. But a general guideline is 7 or more episodes of tonsillitis in 1 year, or 5 or more episodes a year for the past 2 years, or 3 or more episodes a year for the past 3 years. Any decision about surgery should be made with your doctor and be based on your own child's health and well-being.
What is a tonsillectomy?
Tonsillectomy is surgery to remove the tonsils. It's a common surgery, especially in children, but it is not done nearly as often as it was in the past. Tonsillectomy may reduce how often your child gets throat infections. But even without surgery, tonsillitis will probably occur less often as your child gets older.
Your child will get a general anesthetic and will be asleep during the surgery. Your child may go home on the day of the surgery, or he or she may stay in the hospital overnight. Tonsillectomy is usually performed by an otolaryngologist, a doctor who specializes in ear, nose, and throat problems.
Your child may have a lot of ear and throat pain for up to 2 weeks after surgery. A fever up to 102°F (38.9°C) is also common. Your child may also have bad breath for up to 2 weeks.
After surgery, your child will feel tired for several days and then slowly become more active. Your child should be able to go back to school or day care in 1 week and return to full activities in 2 weeks.
What else can you do to treat tonsillitis?
Watchful waiting is a wait-and-see approach to treating tonsillitis. If it seems that your child is getting fewer throat infections over time, he or she won't need surgery. If your child keeps having infections that are getting in the way of daily life, then you and your doctor can decide what to do next.
There are a few things you can do to help your child feel better at home. Over-the-counter medicines (such as acetaminophen) and frozen treats (such as Popsicles) can help relieve a sore throat. Gargling with warm salt water every few hours can also relieve throat pain. Make sure that your child gets plenty of rest.
What are the risks of tonsillectomy?
The risks include some bleeding after surgery. This is common, especially when the healed scab over the cut area falls off. Other risks are much less common. They include more serious bleeding and problems from the anesthesia during surgery. Death during surgery is very rare.
Some children may get upset by being in a hospital.
What are the benefits?
For some children, surgery can greatly improve quality of life. Enlarged tonsils can block your child's upper airway and cause snoring, a stuffy nose, and mouth breathing. Tonsillectomy can help relieve these problems.
Children who have a tonsillectomy because of repeated infections may have fewer and less severe infections for at least 2 years after the surgery. But over time, many children who do not have surgery also have fewer throat infections.
In some cases when a child keeps getting strep throat infections, especially if the infections cause other problems, surgery may be the best choice.
Why might your doctor recommend a tonsillectomy?
Doctors usually only recommend surgery to remove tonsils when a child has repeated infections of the tonsils that are causing serious problems or are affecting a child's quality of life. Any decision about surgery should be made with your doctor and based on your own child's health and well-being.
Tonsillitis caused by a virus usually goes away by itself. It will probably occur less often as your child gets older. Researchers in one study found that surgery is no better than taking a wait-and-see approach for children who get tonsillitis less than 3 times a year.1 Your child may benefit from surgery if he or she is missing a lot of school because of repeated throat infections or has trouble sleeping because of enlarged tonsils.
Doctors don't all agree on how many throat infections in a year point to the need for tonsillectomy. But a general guideline is 7 or more cases of tonsillitis in the past 1 year, or 5 or more cases a year for the past 2 years, or 3 or more cases a year for the past 3 years.
Some of the serious medical problems that may mean your child should have a tonsillectomy are:
- Tonsillitis that lasts longer than 3 months, even with medicine.
- Blocked air passages, which can lead to sleep apnea.
- Trouble swallowing.
- Tonsils that bleed heavily.
Talk with your doctor about the possible risks and benefits of surgery for your child.
Compare your options
Compare
What is usually involved? |
| |
What are the benefits? |
| |
What are the risks and side effects? |
|
- Your child will be asleep during the surgery.
- Your child may go home on the day of surgery or may stay in the hospital overnight.
- Your child may have a lot of ear and throat pain for up to 2 weeks after surgery.
- Your child should be able to go back to school in 1 week and return to full activities in 2 weeks.
- Surgery can improve quality of life for some children.
- Tonsillectomy relieves problems caused by enlarged tonsils.
- Surgery may reduce how often your child gets throat infections.
- Some bleeding after surgery is common.
- Less common risks include more serious bleeding and problems from anesthesia during surgery.
- Over-the-counter medicines and frozen treats can relieve a sore throat.
- Your child should gargle with warm salt water every few hours.
- Make sure your child gets plenty of rest.
- Your child may get better without surgery.
- You avoid the costs, risks, and recovery time of surgery.
- Surgery is no better than taking a wait-and-see approach for children who get tonsillitis less than 3 times a year.1
- Your child may keep having infections that get in the way of daily life.
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
Personal stories about tonsillectomy
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
My son was 5 when he had his tonsils out. It took about 2 weeks for him to fully recover and be able to eat all the things he likes. The first few days after surgery, he was in a lot of pain, but he got better every day after that. Giving him pain medicine helped a lot. The surgery was kind of scary but not as bad as I thought it was going to be.
Leroy, age 32
My daughter has been getting a lot of throat infections. But I really don't like the idea of her having surgery. My doctor says that she will probably grow out of it. I am going to take care of her myself for now and wait and see if that happens.
Maria, age 29
I think surgery would be best for my child. He has missed school from chronic sore throats and doesn't sleep well at night. I'm going to take time off from work so that I can stay home with him after the surgery.
Shannon, age 36
Last year I went back and forth about scheduling a tonsillectomy for my daughter. She wasn't getting sick that often, but I wanted to do the right thing for her. Surgery seemed so drastic. But she has had only one bad throat infection this year. I'm glad I decided not to have her go in for surgery.
Katy, age 40
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to choose tonsillectomy
Reasons to choose other treatment
I'm worried about my child missing school because of repeated infections.
My child isn't missing much school because of infections.
I'm worried about missing more work to take care of my child.
I'm not worried about missing work to take care of my child.
I think the benefits of surgery are worth the small risk.
I'm worried about the risks of surgery.
I want to get my child's tonsillitis taken care of now.
I can manage my child's tonsillitis with home treatment.
I'm not worried about the costs of surgery.
I'm worried about how I'll pay for the surgery.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Scheduling a tonsillectomy
Using other treatment
What else do you need to make your decision?
Check the facts
Is tonsillectomy a good choice if your child has only a few throat infections a year?
- YesNo, that's not right. Surgery may be no better than taking a wait-and-see approach in children who get tonsillitis less than 3 times a year.
- NoYou are right. Surgery may be no better than taking a wait-and-see approach in children who get tonsillitis less than 3 times a year.
- I'm not sureIt may help to go back and read "Get the Facts." Surgery may be no better than taking a wait-and-see approach in children who get tonsillitis less than 3 times a year.
Can tonsillectomy relieve problems caused by enlarged tonsils that block your child's airway?
- YesYou are right. Surgery can relieve problems caused by enlarged tonsils, such as snoring, a stuffy nose, and mouth breathing.
- NoSorry, that's not right. Surgery can relieve problems caused by enlarged tonsils, such as snoring, a stuffy nose, and mouth breathing.
- I'm not sureIt may help to go back and read "Get the Facts." Surgery can relieve problems caused by enlarged tonsils, such as snoring, a stuffy nose, and mouth breathing.
Even without surgery, will tonsillitis occur less often as your child gets older?
- YesYou are right. Even without surgery, tonsillitis will occur less often as your child gets older.
- NoSorry, that's not right. Even without surgery, tonsillitis will occur less often as your child gets older.
- I'm not sureIt may help to go back and read "Get the Facts." Even without surgery, tonsillitis will occur less often as your child gets older.
Decide what's next
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
Certainty
How sure do you feel right now about your decision?
Check what you need to do before you make this decision.
Use the following space to list questions, concerns, and next steps.
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
| Credits | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
| Specialist Medical Reviewer | Charles M. Myer, III, MD - Otolaryngology |
Tonsillitis: Should My Child Have a Tonsillectomy?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the facts
Your options
- Schedule a tonsillectomy for your child.
- Treat tonsillitis with medicines and home treatment.
Key points to remember
- Tonsillectomy may be no better than taking a wait-and-see approach for children who have only a few throat infections a year.
- Your child may benefit from surgery if he or she is missing a lot of school because of repeated throat infections or has trouble sleeping because of enlarged tonsils that may block his or her airway. Talk with your doctor about the possible benefits of surgery for your child as well as the costs and risks of the procedure.
- Tonsillectomy may reduce how often your child gets throat infections. But even without surgery, tonsillitis will probably occur less often as your child gets older.
- For some children, tonsillectomy can greatly improve quality of life. Enlarged tonsils can block your child's upper airway and cause snoring, a stuffy nose, and breathing problems. Surgery can help relieve these problems.
- Doctors don't all agree on how many throat infections in a year point to the need for tonsillectomy. But a general guideline is 7 or more episodes of tonsillitis in 1 year, or 5 or more episodes a year for the past 2 years, or 3 or more episodes a year for the past 3 years. Any decision about surgery should be made with your doctor and be based on your own child's health and well-being.
What is a tonsillectomy?
Tonsillectomy is surgery to remove the tonsils . It's a common surgery, especially in children, but it is not done nearly as often as it was in the past. Tonsillectomy may reduce how often your child gets throat infections. But even without surgery, tonsillitis will probably occur less often as your child gets older.
Your child will get a general anesthetic and will be asleep during the surgery. Your child may go home on the day of the surgery, or he or she may stay in the hospital overnight. Tonsillectomy is usually performed by an otolaryngologist, a doctor who specializes in ear, nose, and throat problems.
Your child may have a lot of ear and throat pain for up to 2 weeks after surgery. A fever up to 102°F (38.9°C) is also common. Your child may also have bad breath for up to 2 weeks.
After surgery, your child will feel tired for several days and then slowly become more active. Your child should be able to go back to school or day care in 1 week and return to full activities in 2 weeks.
What else can you do to treat tonsillitis?
Watchful waiting is a wait-and-see approach to treating tonsillitis. If it seems that your child is getting fewer throat infections over time, he or she won't need surgery. If your child keeps having infections that are getting in the way of daily life, then you and your doctor can decide what to do next.
There are a few things you can do to help your child feel better at home. Over-the-counter medicines (such as acetaminophen) and frozen treats (such as Popsicles) can help relieve a sore throat. Gargling with warm salt water every few hours can also relieve throat pain. Make sure that your child gets plenty of rest.
What are the risks of tonsillectomy?
The risks include some bleeding after surgery. This is common, especially when the healed scab over the cut area falls off. Other risks are much less common. They include more serious bleeding and problems from the anesthesia during surgery. Death during surgery is very rare.
Some children may get upset by being in a hospital.
What are the benefits?
For some children, surgery can greatly improve quality of life. Enlarged tonsils can block your child's upper airway and cause snoring, a stuffy nose, and mouth breathing. Tonsillectomy can help relieve these problems.
Children who have a tonsillectomy because of repeated infections may have fewer and less severe infections for at least 2 years after the surgery. But over time, many children who do not have surgery also have fewer throat infections.
In some cases when a child keeps getting strep throat infections, especially if the infections cause other problems, surgery may be the best choice.
Why might your doctor recommend a tonsillectomy?
Doctors usually only recommend surgery to remove tonsils when a child has repeated infections of the tonsils that are causing serious problems or are affecting a child's quality of life. Any decision about surgery should be made with your doctor and based on your own child's health and well-being.
Tonsillitis caused by a virus usually goes away by itself. It will probably occur less often as your child gets older. Researchers in one study found that surgery is no better than taking a wait-and-see approach for children who get tonsillitis less than 3 times a year.1 Your child may benefit from surgery if he or she is missing a lot of school because of repeated throat infections or has trouble sleeping because of enlarged tonsils.
Doctors don't all agree on how many throat infections in a year point to the need for tonsillectomy. But a general guideline is 7 or more cases of tonsillitis in the past 1 year, or 5 or more cases a year for the past 2 years, or 3 or more cases a year for the past 3 years.
Some of the serious medical problems that may mean your child should have a tonsillectomy are:
- Tonsillitis that lasts longer than 3 months, even with medicine.
- Blocked air passages, which can lead to sleep apnea.
- Trouble swallowing.
- Tonsils that bleed heavily.
Talk with your doctor about the possible risks and benefits of surgery for your child.
2. Compare your options
| Have a tonsillectomy | Treat tonsillitis with medicines and home treatment | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
Personal stories about tonsillectomy
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"My son was 5 when he had his tonsils out. It took about 2 weeks for him to fully recover and be able to eat all the things he likes. The first few days after surgery, he was in a lot of pain, but he got better every day after that. Giving him pain medicine helped a lot. The surgery was kind of scary but not as bad as I thought it was going to be."
— Leroy, age 32
"My daughter has been getting a lot of throat infections. But I really don't like the idea of her having surgery. My doctor says that she will probably grow out of it. I am going to take care of her myself for now and wait and see if that happens."
— Maria, age 29
"I think surgery would be best for my child. He has missed school from chronic sore throats and doesn't sleep well at night. I'm going to take time off from work so that I can stay home with him after the surgery."
— Shannon, age 36
"Last year I went back and forth about scheduling a tonsillectomy for my daughter. She wasn't getting sick that often, but I wanted to do the right thing for her. Surgery seemed so drastic. But she has had only one bad throat infection this year. I'm glad I decided not to have her go in for surgery."
— Katy, age 40
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to choose tonsillectomy
Reasons to choose other treatment
I'm worried about my child missing school because of repeated infections.
My child isn't missing much school because of infections.
I'm worried about missing more work to take care of my child.
I'm not worried about missing work to take care of my child.
I think the benefits of surgery are worth the small risk.
I'm worried about the risks of surgery.
I want to get my child's tonsillitis taken care of now.
I can manage my child's tonsillitis with home treatment.
I'm not worried about the costs of surgery.
I'm worried about how I'll pay for the surgery.
My other important reasons:
My other important reasons:
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Scheduling a tonsillectomy
Using other treatment
5. What else do you need to make your decision?
Check the facts
1. Is tonsillectomy a good choice if your child has only a few throat infections a year?
- Yes
- No
- I'm not sure
2. Can tonsillectomy relieve problems caused by enlarged tonsils that block your child's airway?
- Yes
- No
- I'm not sure
3. Even without surgery, will tonsillitis occur less often as your child gets older?
- Yes
- No
- I'm not sure
Decide what's next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- I'm ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
3. Use the following space to list questions, concerns, and next steps.
| By | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
| Specialist Medical Reviewer | Charles M. Myer, III, MD - Otolaryngology |
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
Last Revised: December 6, 2012
Author: Healthwise Staff
Medical Review: Adam Husney, MD - Family Medicine & Charles M. Myer, III, MD - Otolaryngology
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