What are tonsils?

Tonsils are small glands in the throat, one on each side. They are there to fight germs when you are a young child. After the age of about three years, the tonsils become less important in fighting germs and usually shrink.

Does my child need them?

Your body can still fight germs without them. We only take them out if they are doing more harm than good.

Why take them out?

We will only take your child’s tonsils out if he or she is getting lots of sore throats, which are making him or her lose time from school. Mr Fish will follow nationally agreed guidelines in order to decide if your child’s tonsils should be removed; you may be told that your child does not meet these. Sometimes small children have tonsils so big that they block their breathing at night.

Are there alternatives to having the tonsils removed?

Your child may not need to have his or her tonsils out. You may want to just wait and see if the tonsil problem gets better by itself. Children often grow out of the problem over a year or so. Mr Fish should explain to you why he or she feels that surgery is the best treatment. Antibiotics may help for a while, but frequent doses of antibiotics can cause other problems. A low-dose antibiotic for a number of months may help to keep the infections away during an important period such as during examinations. There is no evidence that alternative treatments such as homeopathy or cranial osteopathy are helpful for tonsil problems. You may change your mind about the operation at any time.

Before your child’s operation

Arrange for a couple of weeks off school after the operation. Let us know if your child has a sore throat or cold in the week before the operation – it will then be safer to put it off for a few weeks. It is very important to tell us if your child has any unusual bleeding or bruising problems, or if this type of problem might run in your family.

How is the operation done?

Your child will be asleep. We will take his or her tonsils out through the mouth, and then stop the bleeding. There are several different ways this can be done, depending on the age of your child, and the reason for surgery. The operation takes about 20 minutes. Your child will then go to a recovery area to be watched carefully as he or she wakes up from the anaesthetic. He or she will be away from the ward for about one to two hours in total.

How long will my child be in hospital?

Your child will either be discharged home later the same day or kept in hospital for 1 night. This will depend on a number of factors including the reason for removing the tonsils, the tim of day the the operation is performed and how your child is afterwards. Either way, we will only let him or her go home when he or she is eating and drinking and feels well enough.

All private paediatric surgery in Cambridge is undertaken at the Nuffield Hospital. If your child is under the age of three than it will not be possible to have the operation done at the Nuffield but Mr Fish can arrange to do the operation privately at Addenbrooke’s Hospital.

Can there be problems?

Tonsil surgery is very safe, but every operation has a small risk. The most serious problem is bleeding. This may need a second operation to stop it. About four children out of every 100 who have their tonsils out will need to be taken back into hospital because of bleeding, but only one child out of every 100 will need a second operation. Please let us know before surgery if anyone in the family has a bleeding problem. During the operation, there is a very small chance that we may chip or knock out a tooth, especially if it is loose, capped or crowned. Please let us know if your child has any teeth like this. Some children feel sick after the operation. We may need to give your child some medicine for this, but it usually settles quickly. It is possible for some tonsil tissue to regrow and need further surgery later in life but this is really rare. If your child’s tonsils are very large then you may notice a change in their voice as the acoustics of the throat will be changed when the tonsils are removed. Some patients notice a change in how food and drink tastes after the operation.

What can I expect after the operation?

Your child’s throat will be sore but will get better day-by-day. Give him or her painkillers regularly, half an hour before meals for the first few days. Do not give more than it says on the label. Do not give your child aspirin – it could make your child bleed. (Aspirin is not safe to give to children under the age of 16 years at all unless prescribed by a doctor).

Encourage your child to eat normal food as this will help their throat to heal. It will help the pain too. They should drink plenty of fluids and stick to bland, non-spicy food. Chewing gum may also help the pain.

Your child’s throat will look white. This is normal while their throat heals. You may also see small threads in their throat – they are used to help stop the bleeding during the operation, and they will fall out by themselves. Some people get a throat infection after surgery, usually if they have not been eating properly. If this happens you may notice a fever and a bad smell from your child’s throat. Call your GP or the hospital for advice if this happens.

Keep your child off school for 2 weeks. Make sure they rest at home away from crowds and smoky places. Keep them away from people with coughs and colds. Your child may feel tired for the first few days, but this is normal, and you should ensure they rest.

Bleeding can be serious

If you notice any bleeding from your child’s throat, you must see a doctor. Either call your GP, call the ward, or go to your nearest hospital casualty department.