Ear Nose & Throat Sydney
Dr  Narinder Singh  MBBS (Syd) FRACS (ORL-HNS) - Consultant ENT Specialist Surgeon - Clinical Lecturer University of Sydney
Ear Nose & Throat Sydney, Dr Narinder Singh
Ear Nose & Throat Sydney, Dr Narinder Singh Ear Nose & Throat Sydney, Dr Narinder Singh
 
Ear Nose Throat

Children

Tonsillectomy

What are the tonsils?

Tonsils are lumps of tissue at the back of the throat.

What is the function of the tonsils?

Tonsils are part of the body's "Early warning system". They detect bugs in the throat.

What problems can occur in the Tonsils?

There are two main problems that may affect your child's tonsils:

  1. The tonsils become too big causing snoring
  2. The tonsils keep getting infected (recurrent tonsillitits)

What happens when tonsils become too big and cause snoring?

If the tonsils are very large, they can block your child's breathing passages at night causing snoring and sleep disturbance. 8-12% of children in Australia snore at night on most nights. In severe cases this can lead to Obstructive Sleep Apnoea (OSA) where your child may temporarily stop breathing at night.

Is snoring different in children and adults?

Snoring in children is very different from snoring in adults. In adults there are many possible causes for snoring. In children, 95% of snoring is due to large tonsils or large adenoids, often both.

Is snoring harmful for children?

Occasional mild snoring in children is probably harmless.

Regular snoring and sleep disturbance in children may lead to the following behaviour problems:

  • Hyperactivity
  • Inattention
  • Aggression
  • Difficulties with learning, memory and problem-solving

Very severe cases of snoring with Obstructive Sleep Apnoea (OSA) may lead to:

  • Developmental delay
  • Growth failure
  • Lung problems

How are big tonsils with snoring with sleep disturbance treated?

When snoring with sleep disturbance is due to big tonsils, the treatment is to remove the tonsils (Tonsillectomy).

What is tonsillitis?

Tonsillitis is when the tonsils become infected.

What are the symptoms of tonsillitis?

When the tonsils are infected, the throat becomes sore and red. It becomes painful and difficult to swallow. The tonsils often swell up and become bigger. The child will often have a fever and feel unwell.

How is tonsillitis treated?

See your GP if you think your child has tonsillitis. Treatment usually consists of bed rest, plenty of fluids, pain relief and antibiotics.

What is recurrent tonsillitis?

Most children will have a few episodes of tonsillitis as they grow up. Some children get repeated episodes of tonsillitis, again and again - this is called "Recurrent tonsillitis".

Is "Recurrent tonsillitis" bad?

Yes. Recurrent tonsillitis can affect your child's health. Multiple courses of antibiotics are not a good idea. Each time your child becomes sick, both you and your child have to take time off.

How is recurrent tonsillitis treated?

Recurrent tonsillitis is treated by removing the tonsils (Tonsillectomy).

When should tonsillectomy be performed?

Official guidelines recommend that tonsillectomy should be considered when your child has the following number of episodes:

  • 7 episodes in the last 12 months OR
  • 5 episodes per year in the past 2 years OR
  • 3 episodes per year for the past 3 years

These are the general guidelines - your child is an individual and the decision as to when to undergo tonsillectomy is based on your child's individual circumstances, your choice and Dr Singh's recommendation.

Wait! The tonsils are part of the "Early warning system". If we remove the tonsils, will my child get more infections?

No.

The tonsils are only 1 part of the "Early warning system". There is a whole ring of tissue around the nose and throat that performs exactly the same function as the tonsils. Removing the tonsils has no effect on the "Early warning system". Millions of tonsillectomy operations have been performed around the world and there is no increase in infections in children who have their tonsils removed.

How are the tonsils removed?

The tonsils are removed while your child is asleep under a general anaesthetic. The tonsils are removed through the mouth - there are no cuts made on the outside.

There are many different ways to remove the tonsils. Older style ways to remove the tonsils include:

  • Blunt dissection (gouging the tonsils out)
  • Sharp dissection (Cutting the tonsils out with scissors or a scalpel)
  • Diathermy/ bipolar/ coagulation/ electrical dissection (Using electricity at high temperature to burn the tonsils out)

Dr Singh uses "Coblation" technology to remove the tonsils.

What is "Coblation"?

Coblation is a modern technology that removes the tonsils at low temperature. The potential benefits of the technology include less bleeding and less pain.

Where is the operation performed?

In the interests of your child's safety, Dr Singh performs children's tonsillectomies at Westmead Private Hospital. Westmead Private Hospital is one of Australia's leading private hospitals. It is part of the Westmead healthcare campus, the largest Hospital complex in the Southern Hemisphere. Westmead Private Hospital is also affiliated with the University of Sydney Faculty of Medicine, Australia's oldest and largest Medical School.

Please note, that we avoid performing tonsillectomy on children under 2 years of age. Children under 2 and any high-risk children who need surgery are referred to have their operation performed only at the nearby Westmead Children's Hospital.

Are there any alternatives to surgery?

Yes. Tonsillectomy is an "Elective" procedure, meaning it is your choice to have the operation performed. Alternatives to surgery include:

  • Do nothing. Your child may keep getting tonsillitis or keep snoring.
  • Long-term antibiotics. Sometimes, a long course of antibiotics for many weeks or months may reduce the risk of recurrent tonsillitis.

Are there any risks to surgery?

Yes. Everything we do in life has risks. Even something as simple as crossing the street has risks...but we still cross the street. Dr Singh will explain the risks of your child's operation and provide you with an information pamphlet that explains the risks in detail. If you have any questions about risks, ask Dr Singh during your consultation.

What should I do next?

See your GP if you think your child has adenoid problems (blocked nose with mouth breathing, snoring, recurrent ear or sinus infections). Your GP will provide a referral to see Dr Singh if surgery is required.



DISCLAIMER: The material on this page represents general information only and is NOT medical advice. For specific medical advice about your individual circumstances you must consult a trained medical practitioner. Always see your GP first. If your GP is unable to resolve your health problem, ask your GP for a referral to Dr Singh. Dr Singh always works together with you and your GP to achieve your best health outcome. IMPORTANT: Do not try to diagnose your medical problem by yourself! Do not rely solely on information found on the internet. Always see your GP first.



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