Does My Child Need Their Tonsils Out?

About Dr. Belinda Mantle

Dr. Mantle’s practice is focused on the diagnosis and management of pediatric patients with common ears, nose and throat disorders. She pursued sub-specialty training in pediatric otolaryngology at Children’s Hospital of Pittsburgh. Dr. Mantle is fellowship-trained in pediatric otolaryngology and is a board-certified diplomate of the American Academy of Otolaryngology/Head & Neck Surgery.

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Question: I took my child to her pediatrician for a sore throat and he told me that she had tonsillitis.  He said that because she was getting tonsillitis so often, she should have her tonsils out.  Should I consider tonsillectomy for my daughter’s tonsillitis?

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There a several reasons a parent should consider tonsillectomy for their child.  To help parents make this important decision, guidelines were established that reflected evidence-based medicine.

According to guidelines, the most common reasons to consider tonsillectomy in children are:

  • recurrent tonsil and throat infections
  • recurrent peritonsillar abscess
  • sleep apnea or sleep disordered breathing

Recurrent tonsil and throat infections

Recurrent infections of the throat and tonsils may suggest the need for tonsillectomy.  Guidelines are in place to help the pediatric otolaryngologist  and parent make the decision as to whether or not your child meets the need for tonsillectomy.

Recurrent peritonsillar abscess

A peritonsillar abscess is a complication of tonsillitis.  Tonsillitis is infection of the tonsils.  Occasionally the infection spreads to the palate (the roof of the mouth).  Here, antibiotics may not effectively reach the bacteria and the infection grows into an abscess (pocket of pus and infected material).  The abscess then must be drained by a procedure (usually surgical in children).  When these occur, they are more likely to recur with later tonsil infections.  For this reason, once an abscess has formed, it is advisable to have the tonsils removed to prevent the future need for abscess drainage.

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Sleep apnea or sleep disordered breathing

Sleep disordered breathing is a spectrum of breathing abnormalities that occur during sleep.  These disorders cause respiratory pauses and gasping during sleep. Obstructive sleep apnea is the most common and severe form of sleep disordered breathing.  In many children who snore and have obstructive sleep apnea, a major triggering factor is enlarged tonsils.  While every child who snores does not need tonsillectomy, many do and evaluation by a pediatric otolaryngologist is warranted.

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