Tonsil & Adenoid Surgery for Children

When to consider tonsil or adenoid surgery

Surgery is often considered when a child has:

• Loud snoring, pauses in breathing, or restless sleep (sleep-disordered breathing or sleep apnea)
• Frequent strep or throat infections, year after year
• Enlarged tonsils or adenoids that make it hard to breathe, swallow, or sleep
• Chronic mouth-breathing, or ongoing ear and sinus problems tied to large adenoids

A straightforward evaluation with Dr. Fewins will tell you whether surgery is the right step — and he'll say so honestly if it isn't yet.

Enlarged tonsils and adenoids

Size matters when it affects function. We look at whether enlarged tissue is interfering with breathing, sleep or swallowing, and how much those problems affect your child. Large tonsils alone are not an automatic reason for surgery.

Snoring and sleep-disordered breathing

Repeated pauses, gasping and restless sleep deserve closer attention than occasional snoring. The history and examination help determine whether enlarged tonsils or adenoids are obstructing the airway and whether a sleep study is needed before a treatment decision.

Recurrent throat infections

Bring the record of your child’s infections, testing and treatment if you have it. We consider how often infections occur, their severity and their effect on school and family life before discussing observation or surgery.

Adenoids and a blocked nose

The adenoids sit behind the nose, where enlarged tissue can contribute to nasal blockage and mouth breathing. We also consider other causes of congestion, including nasal inflammation, rather than assuming every blocked nose needs adenoid surgery.

Gentler techniques, easier recovery

The old approach to tonsillectomy used high-heat electrocautery, which can leave more tissue damage and a rougher recovery. Dr. Fewins uses more precise, tissue-sparing tools:

• Coblation — a low-temperature radiofrequency technique that removes tissue with far less heat. In studies, children treated with coblation had less pain and a shorter recovery than those treated with traditional electrocautery.
• Thermal welding (ENTceps) — a technique that seals as it divides tissue, chosen for markedly less bleeding during surgery and lower pain in the days afterward.

For your child, that translates into what matters: less pain, less bleeding, and getting back to eating, sleeping, and playing sooner. Every child heals at their own pace, and Dr. Fewins will walk you through exactly what to expect.

Dedicated pediatric anesthesia care

Anesthesia is often a parent's biggest worry with tonsil and adenoid surgery — and it's worth asking a question most parents never think to ask: who will give my child anesthesia, and will they be in the room the entire time?

Many hospitals use an accepted anesthesia care-team model in which a CRNA remains in the room while a physician anesthesiologist may oversee more than one operating room. For our pediatric ENT procedures, Dr. Ania Gawel, MD personally provides the entire anesthetic. She is board-certified in both Anesthesiology and Pediatric Anesthesiology, remains with your child from start to finish, and does not simultaneously supervise another room.

An experienced surgeon — and a lower-cost setting

Dr. Fewins performs many of these procedures at a local ambulatory surgery center when that setting is appropriate for the child. In our practice experience, we commonly see families paying less than half—and sometimes close to one-third—of the hospital outpatient cost for the same planned procedure. This is not a guarantee: actual surgeon, anesthesia and facility charges depend on the procedure, insurance network, deductible and benefits.

Ask for a complete estimate before scheduling. If your child needs hospital resources or additional monitoring, the hospital is the appropriate setting regardless of cost.

You may request care with Dr. Fewins. Referral, authorization and network requirements depend on your insurance plan; our team can help you check before scheduling.

What recovery looks like

Most children go home the same day. The first week centers on staying hydrated, cool and soft foods, and steady pain control — Dr. Fewins and his team give you a clear plan and are reachable if you have questions. Most kids are back to school and normal activity within one to two weeks.

Frequently asked questions