Does my child need a tonsillectomy?

A tonsillectomy is routine surgery that can be performed in a day clinic.

Mediclinic’s 10 day clinics accommodate planned, minor procedures, with same-day admission and discharge in most cases. This cost-effective option offers the same high-quality patient care you can expect in our hospitals – and when you bring in your child for a procedure such as a tonsillectomy, a planned and streamlined admission process reduces stress for you both.

Dr Michael Molyneaux, an ENT specialist at Mediclinic Constantiaberg, explains that tonsils and adenoids form part of the immune system. “They sample bacteria and viruses before they spread through the body,” he says. “However, when tonsils and adenoids become infected, they become more of a liability than an asset as they may cause airway obstruction or repeated bacterial infections.”

Similar to lymph nodes that are found in the neck, groin and armpits, tonsils are two round lumps in the back of the throat. Adenoids are located higher in the throat, behind the nose and soft palate, making visualisation of it possible through the mouth or nose without special instruments. “Recurrent infections of the nose and throat, as well as a significant enlargement that causes obstruction to the throat, are common problems affecting the tonsils and adenoids,” Dr Molyneaux says. “Abscesses around the tonsils, chronic tonsillitis, and infections can also make the tonsils and adenoids sore and swollen.”

One symptom of an infected tonsil or adenoid is swelling. Other symptoms may include:

• More red in colour than normal tonsils
• A white or yellow coating on the tonsils
• A slight voice change due to swelling
• Sore throat, sometimes accompanied by ear pain
• Uncomfortable or painful swallowing
• Swollen lymph nodes (glands) in the neck
• Fever
• Bad smelling breath.

“An infected tonsil that can’t be treated with antibiotics will have to be removed in order to prevent the spread of bacteria or breathing difficulties,” Dr Molyneaux says. “Chronic infections of the adenoids can affect other areas such as the Eustachian tube [the passage between the back of the nose and the inside of the ear].” This can lead to frequent ear infections and build-up of fluid in the middle ear that may cause temporary hearing loss.

As Dr Molyneaux explains, the procedure involves removal of tonsils from the back of the throat through the mouth. “This is done with special instruments to ensure access to the tonsils,” he says. “Removal requires dissection of the tonsils off the sides of the back of the mouth area.”

Dr Martin Vanlierde, an ENT specialist at Mediclinic Milnerton, explains that the pain after a tonsillectomy is due to the stiffness of the throat muscles. “The more you chew and eat, the sooner the pain will be relieved; so it’s important to start eating solid foods as soon as possible,” he says. “The area will heal with the formation of a yellow scab. This is a normal healing pattern and does not indicate infection. Days five to seven are the post-tonsillectomy days with the most pain. Patients can expect earache and a mild temperature, which can be treated with the pain medication prescribed at the time of surgery.”