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Paediatric Tonsillectomy

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Paediatric Tonsillectomy Introduction

A tonsillectomy is a surgical procedure to remove the tonsils, which are two small glands located at the back of the throat. Tonsils are part of the immune system and help fight infections, especially during early childhood. However, in some children, the tonsils can become chronically infected, enlarged, or cause breathing and sleep problems.
Tonsillectomy is one of the most common surgical procedures performed in children. It is performed under general anaesthetic as a day procedure or with an overnight stay depending on your child’s age, health, and recovery.

Reasons for surgery

Tonsillectomy is commonly performed for treatment of:

  • Recurrent tonsillitis (frequent throat infections)
  • Sleep disordered breathing / Obstructive sleep apnoea (OSA)
  • Abscess around the tonsil (peritonsillar abscess)

Tonsillectomy may be done alone or combined with other procedures such as adenoidectomy, cautery of inferior turbinates or grommet insertion, depending on your child’s symptoms.

Benefits of the procedure

  • Fewer sore throats and infections
  • Improved breathing and reduced snoring
  • Better sleep quality and behaviour
  • Improved school attendance and participation
  • Less need for antibiotics or missed days due to illness

Risks & complications

Tonsillectomy is a generally safe procedure, but as with any surgery, there are some risks:

  • General anaesthesia risks (low in healthy children)
  • Pain, especially in the throat and ears for 7–10 days
  • Bleeding, which can occur up to 2 weeks after surgery
  • Infection, although this is uncommon
  • Dehydration, from reduced fluid intake due to pain

Bleeding is the most serious potential complication but is uncommon occurring in less than 5% of children when surgery is performed by Dr Phillips. You will be provided with instructions on what to do if this occurs.

Dr Phillips will discuss these risks with you before surgery and answer any questions you may have.

Alternative treatments

If your child’s symptoms are mild or occasional, you may choose to delay surgery and manage the condition with:

  • Antibiotics for infections
  • Pain relief during acute episodes
  • Nasal sprays if allergies are contributing
  • Observation over time (some children grow out of the problem)

Surgery is usually considered when symptoms are persistent, or affecting quality of life.

Pre-operative instructions

Fasting

Your child will need to stop eating and drinking for a certain period before surgery (usually 6 hours for food and 2 hours for clear fluids). The hospital or anaesthetist will give you specific instructions.

Illness

If your child is unwell before the surgery (with a fever, cough, or cold), please contact the clinic, as the procedure may need to be postponed.

Medications

Inform Dr Phillips if your child is on any medications, especially blood thinners, supplements or herbal remedies, as some of these may need to be stopped before surgery.

Procedure details

  • The surgery is done under general anaesthetic and usually takes about 30 minutes.
  • The tonsils are removed through the mouth using special surgical instruments.
  • There are no cuts on the skin and no stitches are usually required.
  • Your child will wake up in the recovery area and be monitored before discharge.

Most children go home the same day, though an overnight stay may be recommended in some cases.

Post-operative care & recovery

Pain

Pain is expected for up to 10–14 days, especially in the throat and ears. Regular pain relief is essential:

  • Use paracetamol and/or ibuprofen as advised
  • Give pain relief regularly, not just when pain is severe
  • If your child refuses oral pain relief, paracetamol can be taken as a suppository
  • Oxycodone syrup may be required when pain is not controlled by paracetamol and ibuprofen. It can cause drowsiness or constipation (it is important to ensure your child is hydrated and take stool softeners or laxatives as required)
  • Post operative pain relief information is always provided at the time of surgery however if you have any further questions please contact our practice.

Bleeding

A small amount of blood-stained saliva is normal in the first day or two. However, fresh red bleeding is not normal and should be treated as an emergency. Go to the nearest emergency department if this occurs.

Diet

  • Encourage your child to eat and drink as normally as possible – there are no diet restrictions
  • Keep your child well hydrated – encourage frequent sips of water or cool fluids.
  • Ice blocks, ice cream and other cool items can reduce swelling and alleviate pain

Activity

  • Rest at home for 7–10 days.
  • Avoid vigorous activity, sport, or swimming for 2 weeks.
  • Children can return to school at two weeks

Breath and Voice Changes

  • Bad breath is common for several weeks after surgery.
  • Some children may sound a little different when speaking – this usually settles with time.

What to watch for

Call our clinic or seek urgent medical care if your child has:

  • Bright red bleeding (more than a tablespoon) – please present to the nearest emergency department for assessment
  • Persistent fever or High fever over 38.5°C
  • It is common to have a mild fever for the first 24-48 hours after the operation
  • Severe pain not relieved by medication
  • Refusal to drink, with signs of dehydration (dry mouth, no tears, fewer wet nappies)
  • Any breathing difficulties

Follow-up instructions

A review appointment will be arranged 4-6 weeks after surgery to ensure your child is healing well. If there are any concerns before this, please contact the clinic. If at any stage you wish to see Dr Phillips, our staff will be happy to arrange an appointment.

Frequently asked questions (FAQ)

  • Will my child get more infections without their tonsils?

    No. Tonsils are part of the immune system, but their removal does not weaken the immune system or increase the risk of infections.

  • Can you still get tonsillitis after tonsillectomy?

    No. The tonsils are removed, however you can still get a sore throat (pharyngitis) when you have a viral or bacterial infection like the rest of the population.

  • When can my child return to school?

    Most children return to school about 2 weeks after surgery, depending on how they are feeling.

  • What happens if bleeding occurs at home?

    Take your child to the nearest emergency department immediately. Bleeding can be serious and requires urgent attention.

Related conditions

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If you’d like to discuss this procedure or explore suitable treatment options, please get in touch with Dr Nicholas Phillips’ clinic.

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To book with Dr Phillips, you’ll need a referral from your GP or specialist. Questions? Call our team — we’re happy to help.