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Tonsillectomy and Adenoidectomy for Obstructive Sleep Apnea and Snoring

Surgery Overview

Tonsillectomy and adenoidectomy are surgeries to remove the tonsils or adenoids. They are:

  • Used to treat obstructive sleep apnea (OSA) in children.
  • Rarely used to treat snoring in adults.
  • Not used to treat snoring in children.

The surgeries almost always require a stay in the hospital.

What To Expect

You may need to be watched closely after surgery. Your doctor or surgeon will watch:

  • Your blood oxygen levels for the first 2 to 3 nights after surgery.
  • For throat swelling, nerve injury, and sleepiness. Both the surgery itself and the medicines used can cause this.

Children who are younger than 3 years and who have other conditions, such as Down syndrome, are more likely to have problems from surgery. The most common is having a hard time breathing. These children may need oxygen therapy or continuous positive airway pressure (CPAP) therapy after surgery.

Why It Is Done

Your doctor may suggest these surgeries to treat sleep apnea if you have swollen tonsils and adenoids that block your airway during sleep. This is often the first treatment choice for children. That's because swollen tonsils and adenoids are often the cause of their sleep apnea.

How Well It Works

In children with sleep apnea, symptoms almost always improve within 6 months of surgery. Parents report a decrease in:

  • Snoring, coughing, and colds.
  • Hyperactivity and other behavior problems.
  • Restless sleep.

In children, these surgeries work well to treat obstructive sleep apnea 75% to 100% of the time. This is true even if the child is obese.footnote 1

Risks

Your throat will be sore after surgery. You may find it hard to eat and swallow for a few days. Other possible problems after surgery include:

  • Infection.
  • A lot of bleeding. (Some bleeding is expected.)

What To Think About

  • Snoring is not always thought to be a medical problem. Your insurance may not pay to treat it.
  • You can't predict if you will have snoring or breathing problems by simply looking at the size of your tonsils and adenoids.
  • If you have other health problems, your doctor may have to treat them before you have this surgery.
  • Tonsillectomy and adenoidectomy are the most common treatments for children who have obstructive sleep apnea.
  • Some children may need to be watched closely before surgery. This includes those who have certain health problems that cause bony deformities of the face and head. These problems include dwarfism and Down syndrome. It also includes children who have had a head injury or who have nervous and muscular disorders, such as cerebral palsy.
  • Children who have other conditions, such as asthma, upper respiratory infections, and heart problems, need to be treated for those problems before and after surgery. This can help reduce the chance of problems from surgery.

Related Information

References

Citations

  1. Schechter MS, et al. (2002). Technical report: Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics, 109(4): E69. Available online: http://www.pediatrics.org/cgi/content/full/109/4/e69.

Credits

ByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Hasmeena Kathuria, MD - Pulmonology, Critical Care Medicine, Sleep Medicine

Current as ofDecember 6, 2017


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