Tonsils and adenoids are often removed at the same time

Your child may have been referred to an ear, nose, and throat (ENT) surgeon to have the tonsils and adenoids removed. This surgery is called a tonsillectomy and adenoidectomy. Often the tonsils and adenoids are removed at the same time. But sometimes only one or the other is removed. Your child’s ENT will discuss this with you.

The tonsils are tissue located on either side of the back of the throat. The adenoids are located behind the nose and at the top (roof) of the mouth. Both the tonsils and adenoids are part of the immune system, the part of the body that fights infection and disease.

Guidelines for pediatric tonsillectomy and adenoidectomy

Health care providers are not in complete agreement about when a child should have a tonsillectomy or adenoidectomy, but here are some guidelines that are followed.


A tonsillectomy may be recommended if your child has throat infections that keep coming back. A throat infection means your child has a sore throat with fever. Or he or she also has swollen neck glands or drainage from the tonsils. Or your child also has a positive strep test. Your child has any of the following:

  • Seven or more throat infections in one year
  • Five or more throat infections in each of two years
  • Three or more throat infections in each of three years

A tonsillectomy may also be recommended if your child has recurrent throat infections and any of these:

  • Is unable to take antibiotic medicine or has antibiotic medicine allergies
  • Has episodes of fever, sores in the mouth, sore throat, and swollen neck glands
  • Has had an infected area near the tonsils

A tonsillectomy may also be recommended if your child has:

  • Abnormal breathing while sleeping with enlarged tonsils. This might be brief episodes where your child stops breathing.
  • Very large tonsils that block breathing through the nose or cause difficulty swallowing


Adenoidectomy is recommended if your child has a lot of trouble breathing through the nose. It may also be recommended if your child has:

  • A long-term (chronic) sinus infection
  • Middle ear infections that keep coming back
  • A chronic middle ear infection with fluid and already has ear tubes

Risks associated with pediatric tonsillectomy and adenoidectomy

All surgeries have risks including bleeding, infection, and complications from general anesthesia. The risks of tonsillectomy and adenoidectomy are:

  • Long-term throat pain
  • Excessive bleeding from the tonsils
  • Damage to teeth, voice box, throat or roof of the mouth, or other nearby tissue
  • Breathing problems

After surgery, your child may have nausea, vomiting, pain, dehydration, ear pain, or throat or lung problems.

Make sure you take your child to all follow-up appointments with the ENT. And call the ENT if your child is not getting better, or if you have any questions or concerns.

To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (1.866.225.5654) or use our secure online appointment request form.