Ear Tubes to Tonsils

10/23/2013 by Penn Medicine Becker ENT & Allergy

What are tonsils? Tonsils are structures in the throat that are part of our immune system. When we are young they help introduce our immune system to foreign substances so that they can be recognized later. In some people, this stimulation causes them to grow quite large and potentially lead to recurrent infections.
Do I need my tonsils? Fortunately, our body has many back-up methods that help our immune system develop. As a result, we don’t experience any deficits following removal of our tonsils.
How do I know if my child needs a tonsillectomy? Recurrent infection (typically strep throat) is one reason your child may benefit from tonsillectomy. This is more typical of school age children. Younger children often have “hypertrophic” or very large tonsils that can cause significant snoring and sleep apnea. If you are concerned about your child’s breathing at night, bringing a short video to your doctor is very helpful.
What is the surgery and recovery like? The surgery is done under general anesthesia and is performed through the mouth (no stitches). It is typically performed in an out-patient surgical center. The recovery is generally 5-10 days of soft diet and liquid pain medicine. As a general rule, the older you are the longer the expected recovery period.
What can I do to prepare my child for tonsillectomy? Just as with adults, children often experience anxiety about surgery and the recovery. Allowing them to participate in the planning often helps alleviate some of these concerns. Taking them shopping to pick out some of their favorite soft foods and drinks is a great way to do this.
What are adenoids? Adenoids are similar tissue to tonsils and are located in the far back of the nose. These are often removed with tonsils for history of recurrent ear infections or nasal obstruction. Adenoids generally shrink on their own when children are 8-10 years old.
What are swollen glands? One of the most common reasons to have swelling in the neck is during an upper respiratory tract or throat infection. Although these swellings are often referred to as “glands” they are actually lymph nodes that swell as part of our immune system responding and fighting the illness. These typically resolve with treatment of the primary illness. If they do not resolve you should seek out evaluation by a physician.
What if my child is not sick? Occasionally a lymph node may swell in the absence of an obvious illness. In children, the immature immune system more commonly causes lymph node swelling and can often be serially observed prior to investigation.
What are ear tubes for? Young children’s anatomy predisposes them to building up of secretions in their middle ear (the space behind the ear). If this fluid gets infected, your child may experience fever, hearing loss and ear pain. If this becomes a chronic problem, small tubes are inserted through the ear drum to connect the middle ear and the outer ear. This allows for the middle ear space to dry out and reduces the frequency and severity of infection.
How do I know if my child needs tubes? A history of recurrent ear infections is typically reported. Some children will build-up fluid without infection causing hearing loss, and this may be hard to notice. The importance of speech and language development at a young age often necessitates intervention. Any child with a speech and language delay should have their hearing tested and ear examined.
Are ear tubes permanent? Typically, these tubes will fall out on their own in 12-18 months and the hole in the ear drum will heal.
What can I expect after surgery? Children generally have minimal discomfort. A week of antibiotic drops are provided to shorten the brief period of drainage. Use old pillowcases and sheets for the first week as some pink to yellow drainage is common. Children are no longer restricted from swimming following tube placement.
What is swimmer’s ear? Swimmer’s ear is an infection of the ear canal. These can usually be treated with drops and water precautions. Tubes are never necessary for swimmer’s ear.

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