Snoring occurs in roughly 10 percent of children on a nightly basis. It results from vibrations of the soft tissues in the throat when there’s an intermittent obstruction or blockage of the airway.
Snoring can be benign or associated with other more serious conditions. About 1 to 3 percent of children’s snoring is related to obstructive sleep apnea (OSA) or sleep-disordered breathing (SDB). Both OSA and SDB can affect your child’s sleep quality and daytime behavior, and can cause restlessness. A sleep study may be recommended to check your child for either sleep-disordered breathing or obstructive sleep apnea.
Typically, a child’s snoring is related to large tonsils/adenoids that cause obstruction in the throat while your child sleeps. At Nationwide Children’s Hospital, we treat thousands of children with snoring, SDB and OSA each year by performing a tonsillectomy and an adenoidectomy.
If your child snores and has obstructive sleep apnea (OSA) or sleep-disordered breathing (SDB), he or she may be recommended to have a tonsillectomy and adenoidectomy. Children with untreated SDB or OSA tend to be tired and irritable, and can have problems with their behavior, attention and learning in school. Chronic, untreated SDB or OSA also can be associated with many serious heart and lung problems that can develop in your child over many years.
Tonsillectomy and adenoidectomy are surgeries to remove tonsils and adenoids in order to improve the size of the airway. Removing your child’s tonsils/adenoids may help them breathe easier at night by relieving obstruction in their throat or opening their airway more fully.
Your child will have surgery at one of outpatient surgery centers located at the main campus or at our Westerville Surgery Center. The surgery will last for about 40 minutes.
Before and after surgery, our pediatric nurses will prepare your child for surgery, assist the pediatric ENT surgeon during surgery and care for your child after the tonsillectomy and adenoidectomy.
Anesthesiology: Your child will be placed under general anesthesia by a pediatric anesthesiologist. Our subspecialty-trained pediatric anesthesiologists provide pediatric anesthesiology services for patients undergoing all surgical procedures at Nationwide Children’s Hospital.
Surgery: A pediatric ENT surgeon will perform their surgery after your child is under general anesthesia in the operating room. The surgery will be performed through your child’s mouth, and the surgeon will use specialized instruments to dissect the tonsils and adenoids from the throat. Only the tonsils and adenoids will be removed during the surgery.
Your child may go home the day of surgery or may stay in the hospital overnight for monitoring. Children frequently have a sore throat for up to two weeks after surgery, and should be encouraged to drink lots of cold liquids. Your child also may be out of school for one to two weeks while he or she recovers.
The pediatric ENT specialist may treat your child’s pain with multiple, liquid medications after surgery. Most children need pain medicine after tonsillectomy and adenoidectomy procedures for up to 10-14 days until their pain has resolved and their throat has fully healed. After surgery, children frequently require pain medicine regularly every four to six hours.
Parents must be watchful of bleeding from the mouth and nose where the adenoids were removed. Bleeding from these areas is not normal after surgery. Should your child have bleeding from their mouth and/or nose after adenoidectomy, he or she should be evaluated as soon as possible at Nationwide Children’s Hospital or at a local hospital.
It is normal for your child to have bad breath for about 1-2 weeks after surgery. They will have scabs form at the sites where the adenoids and tonsils were removed. These begin to dissolve or fall off five to ten days. Once all the scabs in the throat have completely fallen off, the bad breath will go away.
Your child also may complain of ear pain; however this is coming from the throat, and is normal. This pain typically resolves within a week and is not a real ear infection. Your child may have low-grade fevers, typically 101.5 or less, for several days after surgery. If the fever is higher than 101.5 or does not come down with medication, it may be a sign of dehydration or infection. If this is the case, please contact your child’s ENT surgeon for more guidance.
Your child’s surgeon will discuss recommendations about activity and diet for after surgery. It may be difficult for him or her to eat solid foods during the healing period. In this case, encouraging fluid intake and soft foods will be helpful. If your child cannot swallow and drink liquids at home, they may become dehydrated and need to return to the hospital for evaluation.
Frequently, snoring is improved or resolved in children within one month after a tonsillectomy and adenoidectomy. If your child still snores after surgery, your child’s ENT physician may wish to further evaluate to check for other reasons for this persistent snoring. Your child’s tonsillectomy and adenoidectomy surgery may also be combined with our ENT procedures during this same surgery to help with snoring. Your physician will discuss follow up plans with you at the time of surgery.