How to Explain a Tonsillectomy to Your Child

Updated: September 2024

For months–maybe even years– your child has dealt with chronic throat issues and infections. Then, one of our ENTs in Raleigh recommended a tonsillectomy. You’re relieved to have a solution, but one burning question remains:

How do you explain a tonsillectomy to your child? 

The prospect of surgery can be intimidating–even frightening–for children. How you introduce the subject will go a long way toward calming their anxiety. So we’ll take a look at methods centering around how to explain a tonsillectomy to your child, signs your child may need to have one, and your complete guide to tonsil removal.

It’s often difficult for children to understand what tonsils are and why they may have to be removed. If your child is facing a tonsillectomy, you want to be sure he or she understands what is happening. Learning about the process will take a lot of the mystery—and fright—out of the procedure.

At Raleigh Capitol ENT, we utilize the latest state-of-the-art techniques to provide an array of services. From our comprehensive sinus center to transformative facial plastic surgery we have been serving residents of Raleigh and the surrounding areas for decades. We would love to be your medical home. So whether you have seasonal allergies or hearing problems, we invite you to schedule an appointment.

How to Explain a Tonsillectomy to Your Child

It may require some hand-holding. It most certainly will require reassurance and support. There are many important aspects of explaining a tonsillectomy to your child, but above all, the most vital element is to let them know that they are safe and loved.

Following are some important guidelines you should consider when explaining what happens during a tonsillectomy. 

Make Sure You Understand the Procedure

Obviously, you can’t explain the procedure to your child if you don’t understand it yourself. Be sure you don’t have any misconceptions. Remember that, in general, tonsillectomies are performed as an outpatient procedure, so it’s unlikely your child will have to spend the night in the hospital. However, each situation is decided on a case-by-case basis.

We welcome your questions, and we’re dedicated to ensuring you have the answers you need to make both you and your child feel at ease. We suggest making a list of questions or concerns you have. These questions may include:

• How long will I be able to be with my child before the operation?
• Can I see my child in the recovery room?
• What special preparations must we take the night before surgery?

If your child will have to spend the night in the hospital, be sure to ask about visiting hours and staying overnight in the room with your child.

Explain the Tonsillectomy in Age-appropriate Language

It’s a big word, and children can be easily confused. It helps to have age-appropriate educational materials that you can read with your child. You may use a favorite doll or stuffed animal to give your child an idea of what the tonsils are, where they are located and what they do.  

Be wary of frightening words, such as “cutting” or “needles.” Tell the child that the doctor will fix the problem at the hospital.

Your child will be full of questions, the most common of which is “why?” Explain with calming words in a manner he or she can understand.

Calm Their Fears and Anxieties

Many children are afraid the operation will be painful, and it’s important they know about the special doctor called an anesthesiologist that gives medicine to make sure they sleep and won’t feel anything during the operation.

Some precautions: Don’t use the word “gas” when describing the anesthesia because some children confuse it with the gas that goes in a car. If you’ve recently had a family pet “put to sleep” or described a deceased family member as “sleeping,” your child may panic at the thought of being “put to sleep.”

Instead, you can tell your child that during the operation, they will be given medicine to sleep deeply so they won’t feel anything. Emphasize that after the surgery, your child will wake up and you will be waiting for them.

Emphasize That You’ll Be There After the Operation

Tell your child that you will be there when they wake up. Separation is one of the most common fears children experience when faced with surgery. It’s important to let them know that while you’ll be separated during the surgery, you’ll be waiting for them afterward with a favorite toy.

Explain That Your Child Will Have a Sore Throat

Don’t mislead your child by telling them that they will instantly feel better after the operation. It’s fine to tell them to expect a sore throat that will get better. Also, mention that the doctor will give medicine to make the pain go away.

Try Role Playing

You can use some of your child’s dolls, action figures or stuffed animals to show them what will happen during surgery. You may even wish to role play, giving your child an idea of the things they might see or hear.

Encourage Questions

Let your child know that they can ask you any questions. You may even work together on some questions your child wants to ask the doctor. This not only provides assurance, but it sets a good example. Your child needs to know that doctors, nurses and others are there to help. This positive interaction can set the stage for healthy habits moving forward.

While a tonsillectomy is a routine, minor procedure, there’s no such thing as “routine” and “minor” when it comes to your child. A few simple assurances from you will go a long way toward easing your child’s fears.

3 Signs Your Child’s Tonsils Need to be Removed

 If your child has chronic throat infections, it may seem like the tonsils do nothing but cause trouble. In actuality, they do have a role to play as a part of the body’s natural defense against germs. However, when your child has recurrent tonsillitis, removing the tonsils can make a dramatic improvement in their life.

If your child has experienced any of the following, we encourage you to speak with us about whether or not a tonsillectomy would be appropriate:

1. Frequent Throat Infections

This is the most common reason for a tonsillectomy. Recurring infections that cause swollen lymph nodes and a fever may prompt the need to remove tonsils, especially if your child has six to seven infections a year, and the problem has been ongoing for the last three years.

2. Difficulty Swallowing

Enlarged tonsils can make it difficult for your child to swallow.

3. Difficulty Sleeping

Some children have larger tonsils, which may cause difficulty breathing during the night when your child is in a reclined position. This can cause a potentially serious condition called sleep apnea, where your child will stop breathing for several seconds at a time throughout the night. When children fail to get restorative sleep, they can have problems at school, difficulty concentrating, irritability and poor coping skills.

What Do the Tonsils Do?

The tonsils are located at the back of the throat and the soft palate. They are responsible for trapping germs when they enter your body through your mouth or nose. When the tonsils come in contact with these bacteria or viruses, they activate your immune system.

What are the Adenoids, and Why are They Often Removed as Well?

Actually, the adenoids are a part of your tonsils. There are three different types of tonsils:

1. Two palatine tonsils, which are located on either side of your throat. These are the tonsils you can see when you look in a mirror.
2. The adenoids, which are located behind the roof of the mouth in the soft palate.
3. One lingual tonsil, located at the back of the base of the tongue.

The adenoids may also be enlarged and inflamed, which prompts their removal as well.

Is a Tonsillectomy the Right Choice for Your Child?

Tonsillectomies are some of the most common procedures we conduct.  If you’re concerned about the frequent throat infections your child has had, please contact us for an appointment.

Is It Always Necessary to Remove The Tonsils?

When children have difficulty with chronic stuffy noses, continual snoring, and frequent bouts of strep throat, it may be time to “round up the usual suspects.” In this case, the “usual suspects” are frequently the tonsils.

While tonsil removal was once considered a rite of passage, the American Academy of Otolaryngology (AAO) has developed specific guidelines to help ear, nose and throat doctors determine who are the most suitable candidates for a tonsillectomy.

According to the AAO, roughly a half million tonsillectomies are performed in the United States each year, making it the third most common pediatric surgery in the country. (The first two are circumcision and placement of ear tubes.)

Removal of the tonsils—lymph tissues in the throat that are about the size of a walnut—can dramatically improve a child’s quality of life by reducing the number of throat infections he or she experiences.

Is a Tonsillectomy Always the Right Choice?

If your child has had less than seven throat infections in the past year, watchful waiting may be your best course of action. 

Therefore, the AAO has created a set of guidelines and criteria to help guide ENT physicians in determining the best treatment for patients nationwide. These guidelines were created based upon extensive research and evidence-based practice in order to continually improve the quality of patient care.

While every case is different, parents should ask themselves the following questions:

Does My Child Have an Antibiotic Allergy or Intolerance?

An allergy or intolerance can make it difficult to treat chronic throat infections. Remember: antibiotics are not effective against a virus. Any sore throat or respiratory issue caused by a virus will not be resolved by antibiotics.

Is My Child’s Sore Throat the Result of Other Medical Factors?

Depending upon the individual situation, even children with less frequent severe throat infections may still benefit from a tonsillectomy if they have underlying medical factors. These factors may include:

• Peritonsillar abscess – pus collecting behind the tonsil
• PFAPA syndrome. PFAPA stands for periodic fever, aphthous stomatitis, pharyngitis and adenitis.  Aphthous stomatitis is another name for canker sores.  Pharyngitis is swelling and inflammation of the back of the throat. Adenitis is another word for a swollen gland or lymph node.

Does My Child Snore?

If your child has large tonsils, he or she may have difficulty breathing during the night. This is called sleep-disordered breathing (SDB).  The symptoms of SDB are:

• Snoring
• Mouth breathing
• Sleep apnea (pauses for more than ten seconds when sleeping)
• Poor school performance (resulting from lack of quality sleep).

Does My Child Have Down Syndrome or Other Disorders That May Affect the Head and Neck?

Because children with Down syndrome have different facial anatomy, they may have trouble with sleep apnea and SDB. These differences include:

• Narrower throat air passages
• Enlarged tonsils
• Enlarged adenoids
• Difficulty coordinating airway movement
• Large tongue
• Low muscle tone

More information on Down Syndrome and how it can affect sleep can be found through the National Down Syndrome Society.

Tonsillectomies Are Decided on a Case-by-Case Basis

You should realize that a tonsillectomy will not automatically solve their child’s throat problems. In fact, there are certain conditions that are resolved better by a tonsillectomy, and others where the tonsillectomy does not show any statistical difference.

That is just one reason it’s so important for children to have an ENT physician in Raleigh, a specialist who treats diseases of the ears, nose, and throat.

Raleigh Capitol ENT: Serving Patients With Convenient Locations Throughout the Raleigh Area

We have created the perfect combination of world-class care, state-of-the-art medicine, and convenience with locations in:

• Brier Creek
• Cary
• Garner
• Holly Springs
• Raleigh
• Wake Forest

If you or your child are having issues with sore throats, ear aches, or seasonal allergies, we invite you to schedule an appointment to find effective relief.