Tonsils and adenoids are lymph tissues near the throat that filter out germs entering through the nose and throat. When they become infected or enlarged they may obstruct breathing and make sleeping difficult for children. When these problems arise, a tonsillectomy and adenoidectomy or the removal of the tonsils and adenoids may be necessary.

One of the most common ways to perform tonsillectomies and adenoidectomies use heat to cut and cauterize the tissue. The heat causes some injury to surrounding tissue, and can result in a long, painful recovery period. But a new procedure available at UCSF Benioff Children's Hospital called coblation reduces recovery time and pain.

Coblation, which stands for controlled ablation, involves radiofrequency at a low temperature and uses a saline solution to gently and precisely remove the tissues. As a result, the risk of injury to surrounding tissue is much lower.

Dr. Kristina Rosbe, a pediatric head and neck surgeon at UCSF Benioff Children's Hospital, frequently uses coblation for tonsillectomies. "I used to counsel children and their parents that they should expect it to take two weeks for life to return to normal — no pain, normal diet, regular activities," she said. "This technique cuts that recovery period in half."

Nearly all pediatricians now screen for snoring and other sleep problems. In many cases, breathing difficulties may be the result of enlarged tonsils and adenoids, and surgery may cure the problem. What should parents look for?

"Parents should be concerned if their child has loud snoring, stops breathing in his or her sleep, or seems tired or unable to concentrate throughout the day," Rosbe said.

Trouble sleeping, however, also can be due to other problems, such as allergies. Sleep studies and upper airway endoscopies are some of the techniques UCSF may use to pinpoint the cause.

Parents should talk to their pediatricians if their children have breathing and snoring problems. If the doctor thinks that enlarged tonsils may be the problem, he or she should consider refering the child to a surgeon who uses coblation. If surgery is recommended, parents can rest easy knowing that coblation will make it possible for their child's life to return to normal as fast as possible, Rosbe said.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.
Last updated April 13, 2011