Tonsillectomy for tonsillitis is generally used for children who have serious complications or recurrent infections that are unresponsive to other treatment, especially when they interfere with daily functioning. However, tonsillectomy should only be performed after you and your health professional carefully consider your child's medical history and overall health.¹

Researchers in a recent study concluded that tonsillectomy may be no better than watchful waiting for children with mild symptoms, which was defined as tonsillitis occurring fewer than 3 times per year.⁶

For some children, however, tonsillectomy can greatly improve their quality of life. Children who are most likely to benefit from tonsillectomy are those who have:

• Five or more episodes of tonsillitis in a single year, or a recurrence of at least twice per year for more than 2 years in a row. Tonsillectomy is more likely to be considered as treatment when some of these episodes result in missing school, trouble sleeping, or other problems with normal daily functioning.
• Tonsillitis lasting longer than 3 months, despite medicine.
• Obstructed air passages.
• Difficulty swallowing.
• Difficulty talking because of nasal obstruction.
• Tonsils that bleed heavily.

Surgery Choices

Tonsillectomy for strep throat may be performed in cases of recurring tonsillitis that do not respond to antibiotics or if an infection threatens the child's well-being. For more information, see:

Should my child have a tonsillectomy?

New tonsillectomy techniques are currently being evaluated but are not yet widely used. Ultrasonic dissection, cold ablation, laser tonsillectomy, and diathermy tonsillectomy are all techniques that may be offered as tonsillectomy options in the future.⁵

What To Think About

Although tonsillectomy is still the most common major surgical procedure performed on children in the United States, it is not done as often as it was in the past. The tonsils are part of the immune system, and studies have shown that the reduction in future infections following tonsillectomy is not in itself significant enough to outweigh the risks posed by the surgery.¹

Upper respiratory infections and tonsillitis usually occur less frequently as a child gets older.¹ Consider whether your child's tonsillitis infections are manageable until you can wait to see if he or she outgrows them.

A child who has tonsillectomy will require special care and close monitoring for at least a week after the surgery. Consider your ability to provide this care for your child before deciding on tonsillectomy.