How ENT Specialists Manage Tonsillectomy for Children and Adults
Tonsillectomy remains a common procedure carried out by ENT specialists, though the reasons for surgery and the approach differ between children and adults.
In Singapore, where both public and private healthcare institutions manage large numbers of patients with recurrent throat infections and obstructive airway issues, the decision to remove the tonsils is not taken lightly.
Understanding how the procedure is handled across age groups provides clarity for patients and caregivers preparing for surgical intervention.
Reasons for Tonsillectomy in Children
ENT specialists often recommend tonsillectomy for children who experience repeated episodes of tonsillitis, usually defined as multiple infections within a year that disrupt school attendance and overall health. Another common reason is obstructive sleep apnoea caused by enlarged tonsils, which may interfere with normal breathing during sleep. Untreated airway obstruction in younger patients can lead to developmental and behavioural issues, making surgical removal of the tonsils an essential intervention.
Children are less likely to have complications from tonsillectomywhen compared to adults, and their recovery tends to be faster. This outcome influences an ENT specialist’s threshold for recommending surgery in paediatric cases. Parents are also provided with guidance on postoperative care, including hydration, diet adjustments, and pain management, all of which are tailored to support a child’s quicker healing process.
Reasons for Tonsillectomy in Adults
Meanwhile, for adults, ENT specialists consider tonsillectomy under different circumstances. While recurrent infections remain a reason, adults often present with chronic tonsillitis that has not responded to medical treatment or with tonsil stones causing significant discomfort. Obstructive sleep apnoea may also warrant surgery, though in adults it is frequently related to a combination of anatomical factors rather than enlarged tonsils alone.
Adults undergoing tonsillectomyface a higher risk of postoperative bleeding and a longer recovery period compared to children. ENT specialists weigh these risks carefully and may recommend the procedure only when the expected benefits outweigh potential complications. Postoperative care instructions are stricter for adults, especially regarding diet and activity, to minimise the likelihood of bleeding.
Differences in Surgical Approach
The surgical techniques used for tonsillectomy in Singapore are broadly similar for both children and adults, typically involving cold dissection, electrocautery, or newer methods such as coblation. However, ENT specialists adjust the approach based on patient age, size of the tonsils, and overall health condition. Reducing the risk of anaesthetic complications is a priority in children, while in adults, more emphasis is placed on careful haemostasis to prevent bleeding.
Paediatric tonsillectomy procedures are generally shorter in duration and performed in facilities experienced with child anaesthesia. Adult cases may require longer surgical times, and recovery wards are equipped to manage higher risks of complications. These differences reflect how ENT specialists adapt techniques and protocols for safety and effectiveness.
Recovery and Postoperative Considerations
Recovery expectations vary significantly. Children usually return to normal activity within one to two weeks, while adults may take up to three weeks or longer. Pain management strategies also differ. ENT specialists often prescribe milder analgesics for children, while adults may require stronger pain relief due to the intensity and duration of postoperative discomfort.
Hydration and diet are emphasised for both groups, but children are more likely to be encouraged with softer, easily swallowed foods to maintain intake. Adults must adhere to stricter dietary limitations to reduce strain on the surgical site. Follow-up with the ENT specialist, in both cases, ensures that healing progresses without complication.
Conclusion
Tonsillectomy is approached differently depending on whether the patient is a child or an adult. ENT specialists assess medical history, risks, and potential outcomes before recommending surgery, with paediatric patients often benefiting from quicker recovery and lower complication rates compared to adults. Recognising these differences helps patients and caregivers prepare realistically for the procedure and understand the role of specialist care in achieving safe results.
Contact Dr Dennis Chua to ensure timely and informed ENT decisions.
