Should All Enlarged Tonsils Be Removed in Children

What to Do with Enlarged Tonsils

Tonsils and Adenoids are collection of lymphoid tissue that help body fight infections. They trap bacteria and viruses entering the throat and form protective antibodies against them. The tonsils are located on both sides at the back of throat. The adenoids are located higher and further back. where nasal passages connect with the throat. While both tonsils are visible through mouth, adenoids are not.

Many pre-school and even adolescents have large tonsils or adenoids but they need to be left alone as their is high likelihood of their regressing with age. They may get infected occasionally with bacterias but would return back to normal size once infection is over. One of the most common situation where the doctors often advise for their removal is in cases of “recurrent sore throat” or tonsil infection. But according to Scottish Intercollegiate Guidelines Network(SIGN), only in following cases of sore throat, tonsillectomy is advised:

* 5 or more episodes of sore throat in a year
* symptoms have lasted for at least one year
* episodes of sore throat are “disabling and prevent normal functioning”.

Other conditions where doctors commonly advise for tonsillectomy are:

* obstructive sleep apnea
* Peri-tonsillar abscess unresponsive to medical management
* Persistent foul-smell or bad-breath due to chronic tonsillitis not responding to medical management
* Recurrent acute otitis media or chronic serous otitis media

Adenoidectomy for otitis media should not be performed in children under 2 years. Anyways, Tonsillectomy and Adenoidectomy do not appear to decrease the severity or frequency of colds or cough..

Both these surgeries are usually done on outpatient basis 3 weeks after infection has cleared. Surgical complications are few and rare though post-operative pain and swelling may last up to a week.