Removing The Tonsils To Treat Sleep Apnea
Has your doctor recommended a tonsillectomy or are you considering whether or not this would help stop your child’s snoring? Approximately 79% of children who have a tonsillectomy surgery for OSA experienced a resolution of their symptoms. Whereas if you wait, symptoms of sleep apnea will resolve on their own only about half the time. Having a discussion with your physician will help you know if waiting would be the better option for you since there are some risks with having a tonsillectomy.
If you are an adult with sleep apnea, your physician may elect to perform a tonsillectomy to improve symptoms. In those adults who have enlarged tonsils, this may be successful. However, adults usually require CPAP.
Are There Other Studies Of Tonsillectomy For Sleep Apnea
This study followed previous smaller studies showing substantial improvement or resolution in sleep apnea after tonsillectomy alone and that tonsil size and body mass index were associated with outcomes after tonsillectomy alone and that tonsillectomy could reduce the required CPAP pressure in those who did not have resolution of their sleep apnea. This was supported by a larger study of 202 adults published in 2015. This study showed a 95% chance of surgical success after tonsillectomy for sleep apnea, with a decrease in the average apnea-hypopnea index from 18 to 3 events per hour.
Is A Throat Swab Confirming Strep Necessary To Make A Diagnosis Of Tonsillitis
Tonsillitis is diagnosed based on the childâs symptoms and exam. The rapid strep test or strep culture may indicate that this bout of tonsillitis is being caused by the bacteria strep. Determining whether the tonsillitis is caused by strep is important in deciding whether your child needs a penicillin shot or other antibiotic. On the other hand, a specific diagnosis of strep tonsillitis is not necessary when determining the potential benefit of tonsil surgery. Instead, consideration for tonsillectomy is based on the frequency and severity of each tonsillitis episode, regardless the strep results.
Q: Can Tonsil Problems Cause Snoring
A: Yes. Snoring is a key symptom of enlarged tonsils and adenoids, and if they’re left untreated, they can lead to childhood obstructive sleep apnea . Children with this condition may briefly stop breathing during sleep, and their bodies react by partially waking up, which jump-starts the breathing process, often with a gasp or snort. The real problem is that the lowered oxygen levels and constant sleep disruption leave most children tired and cranky. In fact, some kids with OSA are often misdiagnosed with attention deficit hyperactivity disorder , since many of the symptoms are so similar. The cure: a tonsillectomy and/or adenoidectomy, which means surgically removing the tonsils and/or adenoids.
But before you start to worry, it’s important to remember that not all snoring is cause for concern. Roughly 10 percent of children snore, often because of colds, allergies, or routine issues like having a small jaw or small airway. However, you should have your child’s tonsils and adenoids examined if you hear him breathing loudly at night. If your pediatrician suspects problems, he may recommend a sleep study to check for apnea. –Amy Linn
Copyright © 2003 Amy Linn. Reprinted with permission from the October 2003 issue of Parents magazine. Updated 2009
Answered by Parents Team
How Long Will A Tonsillectomy Prevent Me From Singing
While tonsillectomy can help the voice, you won’t be able to sing for a while. After surgery, you need to recover from the removal of the tonsils and the effects that intubation has on your throat.
You will likely have a sore throat for several days immediately following the operation. This is normal and should disappear after a week or less. If pain persists, go see a medical professional.
When you are recovering, take it slow. Rest your voice for around a week. And don’t push yourself too hard when you begin singing again. Start with vocal warmups and exercises and go easy on your voice.
After a week or two, you should be completely ready to take on any gig that comes up!
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What If My Child Still Snores After Surgery
If your child has surgery for snoring then it should help them to breathe easier and sleep more quietly. In most cases, the problem will be solved once your child has fully recovered from the operation. It can take about a month for the full effects to be felt. However, children can still snore for other reasons, for example if they have a cold or are affected by allergies. It is also possible for sleep apnoea in children to causing snoring and breathing problems even without the tonsils or adenoids as the throat can still close up during sleep. If your child continues to snore after a tonsillectomy or adenoidectomy then it is important to talk to your doctor as they may need more treatment for sleep apnoea.
Do I Need Surgery For My Tonsils Or Adenoids
In certain situations, determined by your ENT specialist, surgery may be recommended to remove the tonsils and/or adenoids. Typically, children who have seven episodes of tonsillitis in one year, or five episodes per year for two consecutive years, or three episodes per year for three consecutive years, are considered candidates for tonsillectomy. If a patient has had multiple peritonsillar abscess, surgery may be needed to drain the abscess around the tonsil.
If the tonsils or adenoids are significant enlarged and cause sleep apnea they may be removed as well.
Frequent infections of the adenoids can affect the ears as well. Enlargement of the adenoids can block the eustachian tube. This can lead to frequent ear infections and collection of fluid in the middle ear that may cause temporary hearing loss. Removal of the adenoids may help some children with chronic ear infections accompanied by fluid in the middle ear .
In adults, the possibility of cancer or a tumor may be another reason for removing the tonsils and adenoids.
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Signs Your Child’s Tonsils Are Ready To Come Out
The telltale signs a child may need his tonsils out are pretty common. How many does yours have?
When my son, Patrick, was 3, he started snoring. We thought it was cute at first. Then, as he got older his snoring got louder, and we noticed that he seemed chronically stuffed up and he breathed through his mouth during the day. Our pediatrician told us that he probably had seasonal allergies, but we took him to an ear, nose, and throat specialist just to be sure. His diagnosis: enlarged adenoids . We worried that this signaled tonsil problemsand possible surgerysince big adenoids can lead to swollen tonsils too. Fortunately, antibiotics cleared up most of Patrick’s symptoms and the snoring slowly got better as he got older. His adenoids gradually continued to shrink, and that meant quieter nightsand a less stuffy kid.
Research has shown that many of those surgeries may not have been necessary. Tonsils and adenoids are little glands that trap a lot of germs and prevent your child from getting sick, so they’re the first line of defense against illnesses. Sometimes, though, they become overwhelmed by the foreign invaders and get infected themselves. When that happens, it’s known as tonsillitis and adenoid infection.
What Are The Potential Benefits Of Removing Them
Tonsillectomy and adenoidectomy has an excellent chance of eliminating obstructive sleep problems. If a child has fatigue, irritability, or concentration problems due to poor sleep quality, then these problems can also be improved. A child may eat better and gain weight after tonsillectomy and adenoidectomy. In addition, the surgery often allows a child to breathe better through the nose which potentially can help with normal facial and dental development. Although removal has multiple potential benefits, these benefits cannot be guaranteed in every case.
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How Are Tonsils And Adenoids Evaluated
Your physician will ask about problems of the ear, nose, and throat, and examine your ears, nose, throat, and neck. They may use a small mirror or a flexible scope to see these adenoids.
To determine whether a patient has a viral or bacterial infection, a doctor will typically perform a throat swab. Rapid strep testing can have false negatives, so it is recommended that doctors obtain a throat culture in patients with negative rapid strep testing but who also show symptoms.
Sometimes and Xray may be recommended to assess the size of the adenoids. Blood tests such a Mono tests may be ordered.
A sleep study may be recommended to help decide whether sleep apnea is present and if sleep disturbance may be due to enlarged tonsils and adenoids
What Would I Recommend
We are in the midst of a major change in rethinking sleep apnea surgeryfor all parties involved. The goal is developing a tailored approach to sleep apnea treatment with an approach that is often called personalized medicine. I see many young adults with markedly enlarged tonsils who are struggling with positive airway pressure therapy, including many with mild sleep apnea who are not overweight. For these patients, I think it is very reasonable to think about surgery as a first-line option instead of being on positive airway pressure for the rest of their life. These patients have a greater than 90% chance of clearing up their sleep apnea with tonsillectomy alone. Not every one of them will want to have surgery, but this should be part of the discussion because the results will be so good, based on everything we know about sleep apnea surgery outcomes.
As a sleep surgeon, I see many patients who want surgery because they simply do not like positive airway pressure therapy, even though they are doing well with it. In fact, I actually discourage many of these patients from surgery. My approach is always the same: if you are doing well with positive airway pressure therapy, keep using it. The one caveat are those patients who have a very high chance of resolution of their sleep apnea with a straightforward procedure like tonsillectomy.
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How Can I Tell If My Childs Nasal Obstruction Is From Enlarged Adenoids
Enlarged adenoids, allergies, sinus infections and colds can all cause nasal obstruction. Determining which one is the cause of the obstruction can be difficult. In general, enlarged adenoids cause constant nasal obstruction without significant discharge. In contrast, nasal obstruction from allergies may fluctuate based on different seasons, locations and activities. Allergies often cause other symptoms in addition to nasal obstruction including clear discharge and itchy nose and eyes. Nasal obstruction from sinus infections and colds occurs when the child is sick and is associated with infected secretions.
When To See An Expert
If your child snores, you should consult a pediatrician about the cause of this. This is important because children can also have obstructive sleep apnea, which can be caused by enlarged tonsils or obesity. Additionally, sleep apnea has been linked to growth problems, ADHD, poor school performance, learning difficulties, bedwetting, and high blood pressure.
In adults, occasional snoring is usually not very serious. If you are a habitual snorer, though, it could cause several more serious problems. Heavy snoring can be a sign of sleep apnea. According to the National Sleep Foundation, more than 18 million adults suffer from sleep apnea.
The most difficult part for a patient is to recognize the difference between occasional snoring and sleep apnea.
Not to worry our sleep specialists can help.
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Should My Child Have Tonsil And Adenoid Surgery
The decision to proceed with surgery always involves weighing the potential benefits against the possible complications, postoperative recovery issues, and financial costs. We will only recommend tonsillectomy and adenoidectomy if we feel the potential advantages outweigh the disadvantages. Regardless, only you can determine if your childâs obstruction and associated symptoms are bothersome enough to warrant the risks, discomfort, and costs of surgery. Clinical studies do substantiate that the vast majority of parents are pleased with the results from their childâs surgery and would do it again.
What Will My Voice Sound Like After Surgery
Patients have reported all sorts of positive effects of tonsil surgery. First, no more tonsillitis. Less frequent sore throats, easier breathing, easier speaking, easier singing, and better sleep. Those are already huge benefits!
People report that after having tonsils removed there is more room in the back of their throat.
This can make it easier for singers to bring the voice forward in the mouth and on the soft palate.
The voice will often have a brighter quality after surgery. You may notice a greater degree of freedom and less covering of the vocal sound. Some people even say that it is easier to lift the soft palate when it is not weighed down by tonsils.
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A Look Inside The Throat
Tonsils Throat The throat is located behind the mouth, below the nasal cavity, and above the hollow tube that leads from the throat to the stomach and windpipe is located behind the mouth, below the nasal cavity, and above the hollow tube that leads from the throat to the stomach and windpipe (see figure A… read more are collections of lymphoid tissue that may have a role in helping the body fight infection. They trap bacteria and viruses entering through the throat and produce antibodies. The tonsils and adenoids are largest in children who are 2 to 6 years of age.
The tonsils are located on both sides of the back of the throat. The adenoids are located higher and further back, where the nasal passages connect with the throat. The tonsils are visible through the mouth, but the adenoids are not.
Is There A Test To Determine If A Child Is Having Obstructive Sleep Problems
A sleep study can be performed in the hospital or a sleep lab which records numerous aspects of sleep including breathing pattern, oxygen level, heart rhythm and brain waves. By measuring these parameters, the presence and severity of obstructive sleep apnea can be determined. A formal sleep study is a reasonable consideration if uncertainty exists regarding the degree of a childâs obstructive sleep problems. On the other hand, if a parent describes a sleeping pattern consistent with significant obstruction, most physicians will proceed directly with tonsillectomy and adenoidectomy based solely on parental observations without a sleep study.
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What Eating Problems Can They Cause
Children may be slow eaters and refuse certain foods due to the difficulty in chewing and breathing at the same time. They may have difficulty swallowing and occasional choking. In addition, they may have a poor appetite due to diminished senses of smell and taste resulting from poor airflow through the nose.
When Is Childhood Snoring More Serious
An estimated 10 percent of children who snore may have more serious medical issues, such as obstructive sleep apnea. Pediatric obstructive sleep apnea is a disorder in which a childs breathing is partially or fully blocked repeatedly during sleep. It is best to get this problem treated as soon as it is discovered. If a child is not getting enough sleep because of abnormal breathing during sleep, it could cause fatigue during the day, behavioral problems, learning difficulties, delayed growth, and obesity. Parents of children with sleep-related breathing disorders may also see that their child is having restless sleep, teeth grinding, bedwetting, and gasping or snorting while sleeping.
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Where Are The Tonsils And Adenoid Located
The tonsils are located in the back of the mouth on each side. The adenoid is in the back of the nose. The tonsils can be seen by looking in the mouth, but the adenoids usually cannot be seen on routine exam. Evaluating the adenoid usually requires passing an endoscope through the nose, using a mirror in the back of the mouth or obtaining an x-ray.
Tonsillectomy Or Adenoidectomy For Snoring
When snoring is linked to enlarged tonsils or adenoids, surgery may be recommended to remove them. Removing the tonsils or adenoids is a relatively straightforward procedure and it can be very effective at treating snoring. Surgery can be particularly beneficial when the problem goes beyond snoring and is associated with breathing problems. Sleep apnoea in children can reduce the quality of sleep, leading to behavioural and educational problems during the day. Interrupted breathing can also have serious consequences if it isnt treated. However, if your childs breathing is not affected then it can be better to wait and see if they grow out of snoring as they get older. As the throat grows larger, the tonsils or adenoids may not cause blockages any more.
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Snoring Can Lead To Behavioural Problems In Kids
Kids who snore might not be getting enough rest and quality sleep. Blood flow to the brain can also be affected by snoring. If the child snores they experience oxygen starvation and the brain can suffer.
Some studies are suggesting that many kids diagnosed with ADHD might actually be suffering from poor sleep patterns.
Research has shown that kids who snore are at a higher risk for behavioral problems. Kids who snore are not getting a fully restful sleep. Their concentration, attitude and mood at school can suffer. Poor behaviour and acting out could be the result of an over tired child. In order to improve their attention span, all of the causes of snoring should be addressed.
When Should I See A Doctor About My Swollen Tonsils
If you experience any swelling of the throat or large tonsils, it is important to see a doctor. He or she may recommend you to an ear, nose, and throat specialist, such as New York ENT to help diagnose and remedy your condition. Because enlarged tonsils can indicate more chronic or severe conditions, it is important to consult an expert for evaluation and treatment options.
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