Historically, children had their tonsils removed to reduce the frequency and severity of colds and strep throats. (The tonsils, and the nearby adenoids, all part of the immune system, catch and harbor germs, so removing them can reduce infections.)
Doctors still do take out kids’ tonsils for recurrent throat infections, though many parents these days opt for antibiotics instead. Today, most of the country’s nearly 600,000 tonsillectomies in children are done to correct breathing problems that can disrupt sleep and even lead to trouble paying attention and concentrating in school, said Dr. Dwight Jones, a pediatric otolaryngologist at Children’s Hospital in Boston.
“What happens in many children is that the tonsils get to be large – disproportionate to the mouth and throat – so when the child goes to sleep and the tongue falls back in the mouth, you get obstructive sleep apnea,” the cessation of breathing during sleep.
The result is often loud snoring, restless sleep and both hyperactivity and sleepiness the next day. Some research even links sleep-disordered breathing with ADHD, attention deficit hyperactivity disorder. Bedwetting, for unclear reasons, has also been linked to sleep apnea.
When the tonsils are removed, 83 percent of children with sleep apnea get better, meaning there is no more snoring, no labored breathing or pauses between breaths, said Dr. Stacey Ishman, an assistant professor of pediatric otolaryngology at the Johns Hopkins Children’s Center. School performance also goes up.
Removing tonsils is also getting easier than it used to be. In the old days, doctors used scalpels to remove tissue, which led to considerable bleeding. The excessive bleeding improved when they switched to electrocautery or “hot” probes that used electricity to zap blood vessels so blood did not leak out; but this often burned the throat, leading to more post-operative pain. The latest approach is coblation, which uses high frequency radio waves to sculpt away tonsils from the underlying muscles. With this technique, bleeding is minimal and so is post-op pain because the tissue is not burned.
Bottom line for parents? If your child snores or has labored breathing at night – and has trouble staying awake and paying attention in school – see a pediatric otolaryngologist.