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Tonsillectomy and Adenoidectomy for Obstructive Sleep Apnea and Snoring

Surgery Overview

Tonsillectomy and adenoidectomy are surgeries that remove the tonsils or adenoids. These surgeries 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 typically require a stay in the hospital.

What To Expect After Surgery

You may need close monitoring after surgery. Your doctor or surgeon will watch:

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

Children who are younger than 3 years and who have other medical conditions, such as Down syndrome, are more likely to have complications, especially difficulty breathing. These children may need oxygen therapy or continuous positive airway pressure (CPAP) therapy after surgery.

Why It Is Done

Your doctor may suggest tonsillectomy and adenoidectomy to treat sleep apnea if you have enlarged tonsils and adenoids that are blocking your airway during sleep. This is often the first treatment option for children, because enlarged tonsils and adenoids are usually the cause of their sleep apnea.

How Well It Works

Children who have a tonsillectomy and adenoidectomy to treat sleep apnea usually have a noticeable improvement in their symptoms within 6 months of the surgery. Parents have reported decreases in:

  • Snoring, coughing, and colds.
  • Overactivity (hyperactivity) and other behavioral problems.
  • Restless sleep.

In children, these procedures appear to be successful in treating obstructive sleep apnea 75% to 100% of the time, even if the child is obese.1

Risks

After a tonsillectomy and adenoidectomy, your throat will be sore. This can make eating and swallowing difficult for a few days. Other possible complications after surgery include:

  • Infection.
  • Excessive bleeding. (Some bleeding is expected.)

What To Think About

Snoring is not always considered a medical problem, so your insurance may not pay for treatment.

Simply looking at the size of your tonsils and adenoids cannot predict whether you will have snoring or breathing problems.

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 treatment for children who have obstructive sleep apnea.

  • Children who have certain health problems that cause bony deformities of the face and head, such as dwarfism or Down syndrome, may need close monitoring before surgery. Also, children who have nervous and muscular disorders, such as cerebral palsy, or who have a head injury may need to be monitored closely before surgery.
  • Children who have other conditions, such as asthma, upper respiratory infections, and heart problems, need to be treated for those conditions before and after surgery to reduce the risk of complications.

Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.

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

By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Mark A. Rasmus, MD - Pulmonology, Critical Care Medicine, Sleep Medicine
Last Revised June 17, 2011

Last Revised: June 17, 2011

Author: Healthwise Staff

Medical Review: Anne C. Poinier, MD - Internal Medicine & Mark A. Rasmus, MD - Pulmonology, Critical Care Medicine, Sleep Medicine

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