Surgery

If strep throat continues to recur, you and your doctor may decide you need surgery to remove the tonsils (tonsillectomy). Surgery is considered when you:

• Have recurring episodes of strep throat or tonsillitis in a single year despite antibiotic treatment.
• Have abscesses around tonsils that do not respond to drainage, or if an abscess is present in addition to other signs that you may need tonsillectomy.
• Have persistent bad odor or taste in the mouth, which is caused by tonsillitis that does not respond to antibiotics.
• Need a biopsy to evaluate a suspected tumor of the tonsil.

Large tonsils are not an indication for tonsillectomy unless they are causing one of the above problems or they are blocking the upper airway, which can cause sleep apnea or problems with eating.

Surgery Choices

Tonsillectomy may be done in some cases of strep throat.

An abscess around the tonsils (peritonsillar abscess) may be treated with a simple procedure in which a small incision is made to drain the abscess, although removing the tonsils is appropriate in some of these cases.

What to Think About

Tonsillectomy is no longer routine for children who have frequent sore throats. Surgery has been shown to reduce the number of throat infections for 2 years. But over time many children who did not have surgery also had fewer throat infections.⁵

When you are trying to decide whether to have your or your child's tonsils removed, consider:

• How much time you or your child is missing from work or school because of throat infections.
• How much stress and inconvenience the illness places on the family.

The risks of surgery must also be weighed against the risks of leaving the tonsils in. In some cases of persistent strep throat infections, especially if there are other complications, surgery may be the best choice.