A tonsillectomy is surgery to remove the tonsils.

The tonsils help protect against infections. However, children with large tonsils may have frequent sore throats and ear infections, or have nightly breathing problems. In these cases, surgery to remove the tonsils may be helpful.

The surgery is performed under general anesthesia. This means your child will be unconscious and pain-free. The surgeon holds the mouth open to expose the tonsils. The tonsils are then cut or burned away. Steps are taken to control bleeding, and the cut heals naturally without stitches.

A tonsillectomy should be considered when tonsillitis attacks are so frequent or severe that they affect a child's general health or interfere with school, hearing, or breathing. However, some physicians believe tonsillectomies are done more often than necessary, so get a second opinion when there is any doubt.

Specifically, the guidelines for surgery are:

• 7 or more episodes of tonsillitis in 1 year
• 5 or more episodes per year over a 2-year period
• Enlarged tonsils that interfere with breathing
• An abscess in the tonsils
• Grossly asymmetric tonsils

A tonsillectomy also may be needed if the tonsils are enlarged and blocking access to the adenoids during an adenoidectomy or if the physician suspects the presence of a tonsil tumor.

The risks for any anesthesia include the following:

• Reactions to medications
• Breathing problems

The risks for any surgery include the following:

• Bleeding
• Infection

In rare instances, post-surgical bleeding can go unnoticed and can cause serious consequences. Frequent swallowing may be a sign of bleeding from tonsils.

Other risks include injury to the uvula (soft palate).

In most cases, the surgery clears problems immediately. After surgery, the number of throat infections is usually reduced, but not completely eliminated.

A tonsillectomy is usually done on an outpatient basis, with the child returning home the same day as the surgery. Rarely, the child is observed overnight in the hospital and returns home the day after the surgery. Complete recovery can take 2 weeks.

Expect some throat and ear pain in the first days following surgery. Ice packs can help relieve pain, and sucking on an ice cube or eating ice cream may provide some comfort. In addition, pain-relief medication may be prescribed. During recovery, it is recommended to eat soft, easy-to-swallow food and to drink a lot of cold fluids.

Using a humidifier at home can also bring some comfort. Your child may experience alternating good and bad days for 2 weeks after surgery. It is a good idea to keep your child away from crowds or ill people for 7 days, since the throat is highly susceptible to infections during this period.