My 7 year old regularly suffers from tonsillitis. She has suffered from it on and off for most of her life and I would say that on average, she has it once a month now. This means she is frequently off school and I am concerned because it is particularly unpleasant for her and I am also worried that her school work will suffer as she gets older.
At what stage would an operation to remove her tonsils be considered?
Mr Paul Nix, Consultant Ear, Nose and Throat specialist replies:
Generalised sore throats are quite common and the majority settle with simple painkillers alone.
Such episodes should be distinguished from tonsillitis. When a child has tonsillitis is usually quite obvious with a moderate-severe sore throat making swallowing painful. A fever is usually present and the tonsils become enlarged, inflamed and occasionally are covered in a whitish exudate. It is not unusual to see the neck swollen with enlarged lymph nodes.
Unfortunately the only way of preventing tonsillitis is to remove the tonsils in an operation. As to when this should be performed is basically a balance between the risks of the tonsillectomy (especially bleeding 1%) and the prevention of disabling attacks and loss of school time.
I would generally recommend that a child has to have 5 to 7 attacks of tonsillitis over a minimum period of a year in order to establish a significant and ongoing problem. Alternatively patients also benefit from a tonsillectomy if they have a more prolonged presentation with at least 3 episodes per year for a few years.
The tonsillectomy is usually carried out as a day case procedure and children are advised to have a period of two weeks off activities and school.