Tonsillectomy is a surgical procedure in which the outermost part of the tonsils is removed while the innermost part is preserved. The procedure is performed on children with very large tonsils that cause snoring, restless sleep, or breathing pauses during sleep. The surgery is performed under general anesthesia and typically takes 20-30 minutes. Because only the outermost part of the tonsil is cut, the procedure is gentle with less pain and a lower risk of bleeding than with complete removal.

What is the difference between tonsil reduction and removal?

The difference is how much tonsil tissue is removed. In a reduction (tonsillotomy), only the outer part of the tonsils is removed, while a small core of tonsil tissue is preserved in the throat. In a removal (tonsillectomy), the entire tonsil is removed. In a reduction, the inner part of the tonsil tissue is cut, where there are fewer blood vessels and nerves, and therefore there is less risk of bleeding and less pain after the procedure. Reduction is typically chosen when the only problem is that the tonsils are too large, while removal is chosen in cases of repeated sore throats or chronic inflammation.

When is tonsil reduction offered?

Tonsil reduction is offered when very large tonsils cause discomfort, and this is always a medical assessment. It is especially relevant when the tonsils block the air passage in the throat and cause snoring, restless sleep or pauses in breathing during sleep (sleep apnea). Children who have difficulty eating or swallowing due to the size of the tonsils can also benefit from the procedure. Reduction is often performed together with the removal of childhood polyps (adenotomy), as the two conditions frequently occur together, and the combination has a good effect on the child's breathing and sleep.

How is the operation performed?

The operation is performed under general anesthesia and typically takes 20-30 minutes. The specialist removes the outermost part of the tonsil tissue, making the tonsils smaller while preserving a small core. The procedure is performed on an outpatient basis, and the child can go home the same day after a period of recovery. Tonsil reduction is offered to children from the age of 2.

What is the aftercare like after a tonsillotomy?

The aftercare process is mild for most children, precisely because the procedure is gentle. Most children only experience mild discomfort in the first few days, and any pain may increase after a few days and last up to 7-10 days. Most children can return to kindergarten or school after approximately 4-7 days. You will receive thorough information about the aftercare process and pain relief on the day of surgery.

Can tonsils grow back after a reduction?

Yes, this can happen in some cases because a small part of the tonsil tissue is preserved during the procedure. However, for the vast majority of children, the reduction provides a lasting improvement in breathing and sleep. Should the tonsils later cause problems again, the treatment can be reviewed by a specialist.

Tonsil reduction at Charlottenlund Private Hospital

At Charlottenlund Private Hospital, tonsil reduction is performed on an outpatient basis by ear, nose and throat specialists. We perform a large number of tonsillotomies annually, both for public patients through our tender agreement with the Capital Region of Denmark and for patients with private health insurance. Our anesthesia staff – including pediatric anesthesiologists and anesthesia and recovery nurses with experience in children – organize anesthesia and recovery so that the procedure is as safe as possible for the child. You will find an overview of all departments on our department page.

Sources:

- Danish Society of Otorhinolaryngology (DSOHH): NKR for tonsillectomy.