For most parents choosing whether your child needs surgery or not can be a daunting exercise. With that said, removing adenoids and tonsils can reduce several sleep conditions. A study published by the New England Journal of Medicine confirmed that removing adenoids and tonsils of children can help restore the quality of sleep.
Positive Airway pressure therapy such as CPAP is not ideal for children. That is why surgery is the first line of treatment for obstructive sleep apnea. Tonsillectomy (surgery to remove tonsils) and adenotonsillectomy (surgery to remove adenoids) are some of the most common paediatric surgeries.
The good news is that children who have had these surgeries recover fast. In the US alone, more than 500,000 children undergo these paediatric operations each year. Most of these operations are targeted at helping children with sleep apnea.
How are adenoids and tonsils useful in our bodies?
Adenoids are two clusters of oval-shaped tissues located at the back of the nose. Tonsils are the cluster of lymphoid tissues found at the back of the throat. The two oval-shaped tissues are useful in protecting our bodies from harmful viruses and bacteria that enter through the nose and mouth as you breathe.
In most cases, adenoid will shrink with age. By teenage years, they should be non-existent. Even though these tissues offer protective benefits to our bodies, especially in early life, they can be troublesome. Many children can experience problems with their adenoids and tonsils. Genetics and infections can cause enlargement of these tissues such that they start obstructing the airway.
The above problem is more severe at night because the body is resting in a reclined position. If left unattended, it can lead to obstructive sleep apnea. Sleep apnea can result in restless sleep, irritability, fatigue, and poor coping skills.
At this stage, Dr. Rubinstein of Hudson Valley Sinus Center recommends either tonsillectomy or adenotonsillectomy. These procedures are common among children. But, some adult may also choose to remove tonsils as a treatment for sleep apnea.
Adenoids and Tonsils are usually removed together. If tonsils are the main issue, it is also important to remove adenoids. If adenoids are the problem, and tonsils are unaffected, then you will recover faster if you opt for adenotonsillectomy alone. For children under two years, doctors may remove adenoids alone. For older toddlers, doctors usually remove both tissues.
Why you need to remove tonsils and adenoids?
The best way to treat sleep apnea is to tailor a personalized treatment. There are many young people with enlarged tonsils that are finding it difficult to use any of the positive airway pressure therapies.
So, instead of struggling with different therapies for the rest of their lives, the best treatment option for such individuals is surgery. There is a higher chance of eliminating sleep apnea with tonsillectomy alone in this category of patients. While not all people will prefer surgery, this is one of the best options if you are looking for effective treatment.
A majority of sleep doctor adopt tonsillectomy and adenotonsillectomy as the first-line treatment for sleep apnea in children. Tonsillectomy is also an effective first-line treatment for sleep apnea in adults.
Part of the reason why many patients will prefer surgery is that they have a problem coping with the positive airway pressure therapy. If you have trouble breathing, the doctor will assess the severity of your condition and how well positive airway pressure therapy is working for you. If it is working for you and you are okay with it, then you can keep using it. But, you have a higher chance of resolving sleep apnea with a proper procedure such as tonsillectomy
If there is one immediate change that you will notice after the surgery, it should be a better quality of life. Tonsillectomy and adenotonsillectomy can lead to improved cognitive behavior. Children that have gone through the surgery can show improvement on emotional control. Some will see improvements in organization skills, impulsiveness, and quality of sleep.
How to prepare yourself or your child for a tonsillectomy and adenotonsillectomy
Before doing any surgery the doctors will do several tests. In most cases, a sleep study is done to ascertain the extent of sleep problem. The ear, nose, and throat (ENT) surgeon will then inform you about the condition and treatment. This is also the time to ask any question you may have. Make sure, you have clarified the following things with your doctor.
- Medicine that your child should avoid before the surgery.
- The kind of care needed after the surgery.
- How long will it take your child to return to normalcy include going back to school .
- What food or medicine your child should not take immediately after the surgery.
The above should help you make better plans to ensure smooth operation and recovery. If your child gets sick immediately before the surgery, report to your doctor. Depending on the situation, the surgery may be postponed.
In most cases, the surgery will take less than an hour. General anaesthesia may be used, though not necessary. Fluids and medicine will be given by IV. Unless the condition is severe, you will rarely stay overnight.
Removing tonsils and adenoids as part of sleep surgery is a well-tolerated procedure. It is possible for children or adults who have undergone the procedure go home the same day. The recovery is between 1-2 weeks. These surgeries may also help with tonsil stones and peritonsillar abscess, especially if the infection spread beyond the tonsil.
If you think you or your child has enlarged adenoids or tonsils that is affecting your sleep, please talk to Hudson Valley Sinus Center to schedule an appointment with Dr. Ran Rubinstein. He is one of top ENT surgeons in New York specialising in nasal, allergic, and sinus disorders. Besides being a board certified by the American Board of Otolaryngology, he is also a respected fellow in the American Academy of Otolaryngic Allergy.