Tonisllectomy is the third most common surgery in the U.S. for children, with more than 530,000 procedures performed annually in children under age 15. Dr. Wasyl Szeremeta, pediatric otolaryngologist and Division Chief of Pediatric ENT at Stony Brook Children’s Hospital, wants parents to be more aware of this procedure. Here, he talks about when and why a child should have a tonsillectomy and why specialized pediatric expertise is so important.
First, what is pediatric ENT?
This medical subspecialty is concerned with ear, nose and throat conditions in children — everything from sleep apnea and airway problems to hearing issues, congenital malformations and throat conditions such as tonsillitis and adenoid problems. As the only hospital in Suffolk County with a fellowship-trained pediatric otolaryngologist (head and neck surgeon) — as well as an ENT team that works closely with other divisions including pediatric pulmonology, pediatric anesthesiology, genetics, endocrinology and the pediatric intensive care unit (PICU) — Stony Brook Children’s allows families to receive advanced ENT care close to home.
What are tonsils and when should a child get a tonsillectomy?
Tonsils are two soft tissue pads located on both sides of the back of the throat, just behind the teeth. Typically, tonsillectomy is recommended if a child has frequent throat infections or if the child shows signs of obstruction while sleeping.
Typically, the procedure results in fewer throat infections, doctor visits and antibiotic use, as well as improved quality of life, particularly if the child’s sleep or breathing has been disrupted.
Tonsils usually are enlarged when they get infected, but some children have large tonsils to begin with. Enlarged tonsils can obstruct breathing at night, leading to snoring, mouth breathing and sleep apnea. While snoring by itself does not necessarily mean that your child has a clinically significant obstruction that might result in apnea (stopping breathing) or hypopnea (slowing down of the breathing), it does not mean that your child is safe either. Signs of obstructive sleep apnea may include, snoring, restless sleep, mouth breathing, drooling at night, bed wetting, morning irritability, night terrors, poor daytime attention and poor school performance. If your child has any of these symptoms, then he or she should be evaluated for the presence of a sleep distrubance, and a tonsillectomy may be recommended.
Is tonsillectomy safe?
While all surgeries carry some risk, tonsillectomy is an extremely safe procedure offering excellent recovery rates and outcomes. Often done on an outpatient basis under a general anesthesia, it typically takes less than an hour. Some children, however, may have other medical issues, such as asthma or sleep apnea, that increase their risk. These are children with any type of breathing, sleep or airway problem. At Stony Brook, children at higher risk (as well as those under age three) stay overnight after their tonsillectomy — either in the general pediatric unit or in the state-of-the-art Pediatric Intensive Care Unit (PICU) — and are carefully monitored for complications.
Should my child have the procedure at Stony Brook even if he or she is not high risk?
Absolutely. Actually, it is a good idea for all children’s procedures to be performed at a children’s hospital — minor and major. At a children’s hospital such as Stony Brook Children’s, physicians are highly trained in the physical, emotional and developmental needs of children at every age, and thus can offer individualized and appropriate care for your child. Most of the nurses and other team members have spent their careers only caring for children. Not only do they have training and experience to meet children’s needs, they know how to talk with children and families. But probably most important, a children’s hospital has the resources and expertise to keep a child safe if complications should arise — with 24/7 access to specialized surgeons, a pediatric emergency department, the PICU and other highly specialized services. Children’s hospitals also provide comprehensive services.
This means that children get the care they need, when they need it, by the appropriate provider, in the appropriate setting.
To learn more, call (631) 444-KIDS (5437).
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