February is Kids’ ENT Health Month, and Lake Regional’s Keith Bonacquisti, M.D., a board-certified otolaryngologist, is addressing a question he gets a lot from parents: When is it a good idea to remove a child’s tonsils?
“Tonsillectomy can improve the quality of life in children who struggle with certain recurrent sore throats or who have enlarged tonsils that interfere with breathing,” Dr. Bonacquisti said. “An ENT specialist can determine if a child will truly benefit from this surgery.”
Dr. Bonacquisti gives more details on the two most common reasons for removing a child’s tonsils.
Recurrent sore throats. “If a child is having throat infections again and again, as often as every few weeks, that child may have chronic tonsillitis,” Dr. Bonacquisti said.
Still, not all patients who have chronic tonsillitis require surgery.
“Some children have frequent but mild sore throats that don’t interfere with their lives much,” Dr. Bonacquisti said. “These children likely do not need surgery. Other children have fevers, feel crummy, cannot go to school and frequently need antibiotics for strep throat. These are the children who might benefit from a tonsillectomy.”
Enlarged tonsils in children. Although people tend to think of sore throats leading to tonsil removal, the most common reason by far for pediatric tonsillectomies is enlarged tonsils.
“Up to 90 to 95 percent of tonsillectomies and adenoidectomies are done because enlarged tonsils and adenoids are obstructing the child’s airway,” Dr. Bonacquisti said. “The first clue is often mouth breathing and snoring.”
Snoring might not sound like a serious problem, but it tends to go along with obstructive sleep apnea. Children with obstructive sleep apnea experience short interruptions to their breathing while sleeping, resulting in a poor night’s rest that can lead to other health and behavior problems.
In addition, chronic mouth breathing while sleeping may restrict proper growth of the face and jaws. This restricted growth is a common cause of temporomandibular joint syndrome (TMJ), which can cause chronic ear pain, facial pain and headaches. It also can lead to an increased risk of developing obstructive sleep apnea later in life.
“Every parent should periodically check to see if their children are breathing through their nose while sleeping,” Dr. Bonacquisti said. “If they are chronically mouth breathing or snoring, they have an anatomical upper airway obstruction and should see an ENT.”
What to Expect with Surgery
Tonsillectomy is a common procedure with low risks.
“The procedure takes only about 20 minutes, and it’s done on an outpatient basis,” Dr. Bonacquisti said.
Dr. Bonacquisti uses Coblation for tonsil and adenoid surgery because it reduces recovery time, reduces pain, reduces the operative time required and enables an essentially bloodless procedure. Because it uses lower temperatures than other methods, Coblation results in less thermal injury to the underlying tissue.
Dr. Bonacquisti treats many other ailments and disorders at Lake Regional ENT & Audiology, including ear infections, sinusitis and allergies. Learn more about his pediatric and adult services at lakeregional.com/ent. To make an appointment, call 573.302.2864.