42820 Tonsillectomy and adenoidectomy; younger than age 12

Name of the Procedure:

Tonsillectomy and Adenoidectomy for Children Under Age 12
Commonly known as: T&A Surgery

Summary

A tonsillectomy and adenoidectomy (T&A) is a surgical procedure to remove the tonsils and adenoids, which are tissues located in the throat and behind the nasal passages, respectively. This procedure is commonly performed on children under the age of 12 to treat chronic infections and breathing problems.

Purpose

The procedure addresses recurrent throat infections, sleep apnea, difficulty breathing, snoring, and chronic adenoiditis. The goals are to reduce infection frequency, improve breathing, and enhance overall quality of life.

Indications

• Recurrent tonsillitis (typically more than 7 episodes in 1 year, or 5 episodes per year over 2 years)
• Obstructive sleep apnea
• Difficulty breathing due to enlarged tonsils/adenoids
• Chronic ear infections linked to adenoiditis
• Persistent snoring

Preparation

• Fasting is usually required for several hours before the surgery.
• Preoperative blood tests or physical examinations may be conducted.
• Parents should inform the doctor about any medications the child is taking; some medications may need to be paused.

Procedure Description

1. The child will be given general anesthesia to ensure they are asleep and pain-free during the surgery.
2. Surgical instruments are used to remove the tonsils and adenoids through the mouth, without any external incisions.
3. Hemostasis (stopping of bleeding) is achieved using techniques like cauterization or surgical sutures.
4. The child is monitored in the recovery room until they wake up.

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

T&A surgery is usually performed in a hospital or outpatient surgical center.

Personnel

• ENT (Ear, Nose, and Throat) Surgeon
• Anesthesiologist
• Surgical Nurse
• Recovery Room Nurse

Risks and Complications

• Common risks: Bleeding, infection, swelling, and pain.
• Rare risks: Adverse reaction to anesthesia, damage to surrounding tissues, dehydration due to difficulty swallowing.

Benefits

• Reduced frequency of throat infections
• Improved breathing and sleep quality
• Enhanced overall health and fewer missed school days Results are often noticeable within a few weeks post-surgery.

Recovery

• Pain management will include prescribed painkillers and hydration.
• Soft foods are recommended initially (e.g., ice cream, broths).
• Strenuous activities should be avoided for about 2 weeks.
• Follow-up visits are scheduled to monitor healing.

Alternatives

• Antibiotic therapy for infection management
• Continuous Positive Airway Pressure (CPAP) for sleep apnea
• Watchful waiting to see if the condition improves over time Non-surgical options may offer temporary relief but might not provide the long-term benefits of T&A surgery.

Patient Experience

During the surgery, the child will be under general anesthesia and feel no pain. Postoperatively, they may experience a sore throat and mild discomfort, managed with pain relief measures. Temporary changes in eating and activity levels are expected, with gradual improvement over the following weeks.