Throat Condition

Tonsillectomy and Adenoidectomy for Obstructive Sleep Apnea and Snoring

Surgery Overview

Tonsillectomy and adenoidectomy are surgeries to remove the tonsils or adenoids. The adenoids are above the tonsils and behind the nose. Your doctor will do the surgery through your mouth. You will be asleep. Most people go home that same day.

These surgeries are:

Used to treat obstructive sleep apnea (OSA) in children.
Rarely used to treat snoring in adults.
Not used to treat snoring in children.

The tonsils and adenoids are made of lymph tissue in the throat. They help make substances (antibodies) that help the body fight infection. The tonsils can be seen on either side of the throat at the back of the mouth. The adenoids are higher in the throat and usually cannot be seen. The uvula is the small, finger-shaped piece of tissue that hangs down from the soft palate in the back of the throat. It can usually be seen when the mouth is open wide.

What To Expect

You may need to be watched closely after surgery. Your care team will watch:

Your blood oxygen levels.
For throat swelling, nerve injury, and sleepiness. Both the surgery itself and the medicines used can cause this.

Your throat will be sore after surgery. You may find it hard to eat and swallow for a few days.

Children who are younger than 3 years and who have other conditions, such as Down syndrome, are more likely to have problems from surgery. The most common is having a hard time breathing. These children may need oxygen therapy or continuous positive airway pressure (CPAP) therapy after surgery.

Oxygen Therapy

Oxygen therapy means using an oxygen tank or a machine to breathe in air that contains more oxygen than normal.

Oxygen therapy increases the amount of oxygen in the lungs and the bloodstream. A person with a health problem such as chronic obstructive pulmonary disease (COPD) may need oxygen therapy if there are signs that the cells of the body are not getting enough oxygen.

Oxygen therapy may be given by different methods, including a:

Tube placed under a person’s nose (nasal cannula).
Plastic mask placed over a person’s mouth and nose.
Tube (endotracheal tube) placed into the mouth and down the windpipe of a person who cannot breathe independently. The tube is attached to a machine (ventilator) that breathes for the person.

Continuous positive airway pressure (CPAP)

Continuous positive airway pressure (CPAP) is treatment provided by a machine worn at night or during times of sleep to treat sleep apnea, a sleep disorder in which a person regularly stops breathing during sleep for 10 seconds or longer. A CPAP machine increases air pressure in the throat, keeping tissues in the airway from collapsing when a person inhales.

The CPAP machine delivers air through a mask that covers the nose and mouth, through a mask that covers only the nose, or through a nasal pillow that covers only the openings of the nose.

CPAP is the most widely used treatment for sleep apnea caused by blocked airflow in the throat (obstructive sleep apnea).

Why It Is Done

Your doctor may suggest these surgeries to treat sleep apnea if you have swollen tonsils and adenoids that block your airway during sleep. This surgery is often the first treatment choice for children. That’s because swollen tonsils and adenoids are often the cause of a child’s sleep apnea.

How Well It Works

In children with sleep apnea, symptoms may get better over time. Caregivers reported a decrease in things such as:

Snoring, coughing, and colds.
Some behavior problems.
Restless sleep.

Some children with sleep apnea who do not have the surgery also get better over time.

Risks

Possible risks after surgery include infection and a lot of bleeding. Some bleeding is expected.