Helping you decide about tonsil surgery for your child

About tonsillitis

Your tonsils can be found on either side of the back of your throat. When they become swollen and inflamed, we call this tonsillitis. This is usually caused by an infection from viruses or bacteria. Tonsillitis is a common illness in children. Most childhood tonsillitis is caused by viruses. Your child will be ill with a sore throat and a fever.

Figure 1. Large, infected tonsils (red and covered in white spots or pus)

Managing your child’s symptoms

There are some simple ways you can help your child’s tonsillitis. You can use paracetamol (Calpol, for example), or ibuprofen, or both. If your child is old enough, you can also use soothing treatments, such as over-the-counter throat lozenges and throat sprays. Gargling with a mild antiseptic or warm, salty water can also help. Most cases get better within a week.

Watchful waiting

This means making a note of how often the infections happen and how bad they are. This helps you see if they are getting better or worse. You can keep a Tonsil Diary on a sheet of paper or keep notes in your mobile phone. You should still manage your child’s symptoms when they appear.

If your child’s tonsillitis is caused by bacteria, your doctor may prescribe antibiotics. These can help treat the infection.

What next? Deciding about surgery

Surgery involves having an operation called tonsillectomy to take the tonsils out. This is done while your child is asleep under a general anaesthetic.

This may be an option if your child has had:

• seven or more sore throats in the last year that have been bad enough for you to take them to a doctor

or

• five or more sore throats like this in the last two years

or

• three or more sore throats like this in the last three years.

Tonsillectomy

Tonsillectomy can help your child’s symptoms, but as with any surgery, there are risks involved. It is important that you understand the possible risks when deciding what to do.

Going back to the hospital

Almost 1 in 10 children (9%) who have a tonsillectomy have to go back to the hospital afterwards because of complications.

• Bleeding: Just over 1 in 20 children (6%) have bleeding which means they must go back to the hospital.
• Further surgery: 1 out of 100 children (1%) who have bleeding need a second operation to make it stop.
• Other reasons: About 1 child in 33 who has a tonsillectomy (3%) feels pain, vomits or has an infection bad enough that they must go back to hospital for treatment.

Blood transfusion

Things to think about when deciding if surgery is the right choice for your child.

What is important to you and your child?

Use these questions to think about what matters to you and your child. This should help you to decide about surgery for your child.

I do not want my child to have a treatment with a risk of complications

The most important thing is that my child has fewer sore throats

I don’t mind waiting and see if my child gets better on their own

I have concerns about my child having an operation and a general anaesthetic

Tonsillitis has stopped my child doing things at home and at school or nursery

I want a treatment that means my child does not have to take time off school.

ENT UK would like to thank the authors and reviewers for their contribution

Disclaimer: This publication is designed for the information of patients. Whilst every effort has been made to ensure accuracy, the information contained may not be comprehensive and patients should not act upon it without seeking professional advice.