Dr Amir Ajar
Tonsil Disease In The Pediatric Population
Tonsil surgery is one of the most commonly performed pediatric procedures in the US, with over 500,000 cases performed annually. Indications for surgery in children include recurrent tonsil infections and trouble with breathing during sleep- both of which have significant potential to adversely affect quality of life. Repeated infections carry significant burden related to outpatient/ER doctor visits, antibiotic use/complications, as well as missed work/school related to illness. Obstructive sleep apnea in the pediatric population has been associated with behavioral problems, poor school performance and decreased quality of life - comparable to other chronic medical conditions such as asthma and juvenile rheumatoid arthritis. This has to be weighed against the risks of the procedure, which include potential general anesthesia, operative and post operative recovery complications.
Surgical procedure and expected recovery
Tonsil surgery is usually same day surgery. As mentioned above, this surgery is performed with the patient asleep, with a breathing tube. The expectation with this surgery is that the child will be discharged home after observation in the recovery room, but there are times patients are kept over night (for example if they are pain or nausea afterward that might cause problems at home).
A word about adults
While there are established and agreed upon criteria for recommending tonsillectomy for children, indications for adults are less clear. In my practice, my approach toward discussing tonsillectomy in adults is based on a careful discussion together of the risks and benefits associated. This requires a conversation about how much of a problem the tonsils are, against the risks of surgery and expected recovery post-surgery. As far as sleep apnea in adults (and older adolescents for that matter), care needs to be taken when approaching tonsil surgery as a stand-alone option. This is because only in rare cases will addressing tonsils in isolation prove an effective measure in addressing sleep apnea in adults.
What to do next
If you or your loved one have been having tonsil troubles, our office would be happy to discuss your options of management. The idea of a potential tonsillectomy is something that commonly creates worry, but it does not need to.
Amir H. Ajar, MD FACS
Otolaryngology-Head and Neck Surgery
3655 Lomita Boulevard, Suite #308
Torrance, CA 90505