Researchers compared two different ways doctors remove tonsils and adenoids (small glands in the throat) from children. They found that a newer surgical technique called PITA caused more fevers in the week after surgery compared to the traditional cold method. However, the newer technique had some benefits—kids felt less pain and got back to eating normal food faster. The study included 82 children and found that about 1 in 4 kids developed a fever after surgery, with the newer method being about 5 times more likely to cause fever. While fevers are concerning, they were manageable, and parents just need to know what to expect.

The Quick Take

  • What they studied: Whether the type of surgery used to remove tonsils and adenoids affects how often children get fevers afterward
  • Who participated: 82 children with an average age of 5 years old who needed tonsil and/or adenoid removal surgery. About 56% were boys. Half had the traditional surgery method, and half had the newer PITA method.
  • Key finding: Kids who had the newer PITA surgery were about 5 times more likely to develop a fever in the week after surgery (about 45% of PITA patients vs. 10% of traditional surgery patients). Overall, about 1 in 4 children developed a fever after surgery.
  • What it means for you: If your child needs tonsil or adenoid surgery, talk to your doctor about which method they’ll use. The newer PITA method may cause more fevers but causes less pain and lets kids eat normally faster. Fevers are manageable with proper care, but you should be prepared to monitor your child’s temperature and know when to call the doctor.

The Research Details

This was a prospective cohort study, which means researchers followed children forward in time after their surgery to see what happened. They compared two groups: one group had traditional ‘cold’ surgery (using cold instruments to remove tissue), and another group had the newer PITA method (using powered instruments like a coblation tool or microdebrider to carefully remove tissue while leaving the outer capsule intact). The study took place at a major hospital from June 2023 to November 2024, and researchers carefully tracked what happened to each child for one week after surgery.

The researchers measured several things: whether kids got fevers over 100.2°F, how much pain they had, how quickly they returned to eating normal food, whether they had any bleeding, and whether they needed to see their doctor again. They used standard medical tools to measure pain and carefully documented all complications.

This type of study is useful because it follows real patients in real-world conditions, which helps doctors understand what actually happens after surgery rather than just what might happen in theory.

Understanding which surgical technique causes more fevers is important because fevers can worry parents and sometimes lead to unnecessary doctor visits or emergency room trips. By knowing which method is more likely to cause fevers, doctors can better prepare families and help them manage expectations. This information helps doctors choose the best technique for each individual child based on what matters most to that family.

This study has some strengths: it carefully tracked children after surgery, used clear definitions of what counts as a fever, and measured multiple outcomes. However, the study is relatively small (only 82 children) and was done at just one hospital, so results might be different in other places. The study was also recent (2023-2024), so it reflects current surgical practices. The researchers were transparent about what they measured and how they measured it, which is a good sign of quality research.

What the Results Show

The main finding was that children who had the newer PITA surgery were significantly more likely to develop fevers in the first week after surgery. Specifically, 19 out of 42 children (45%) who had PITA developed fevers compared to only 4 out of 40 children (10%) who had traditional cold surgery. This means the newer technique was about 5 times more likely to cause fever.

Interestingly, the newer PITA technique had some clear advantages. Children who had PITA reported much less pain—their pain scores were about 3.4 out of 10 compared to 4.1 out of 10 for traditional surgery. While this might not sound like a huge difference, it was statistically significant and meant kids felt noticeably better. Additionally, children who had PITA got back to eating normal food much faster—on average 3.4 days compared to 4.1 days for traditional surgery.

Another important finding was that more children in the PITA group needed to contact their doctor or return for a visit (36% vs. 15%). This was likely because parents were concerned about the fevers. However, there were no major differences in serious complications like bleeding, and the rates of bad breath after surgery were similar between the two groups.

The study looked at several other outcomes beyond fever. Bleeding rates were similar between both surgical techniques, which is reassuring since bleeding is one of the main risks of tonsil surgery. Readmission rates (children who had to go back to the hospital) were also similar. The rate of halitosis (bad breath), which can happen after tonsil surgery, was not significantly different between the groups. These findings suggest that while PITA causes more fevers, it doesn’t appear to cause more serious complications overall.

This is one of the first studies to directly compare fever rates between these two surgical techniques. Previous research has shown that PITA is a gentler technique that causes less pain and allows faster recovery, which this study confirms. However, the finding about higher fever rates with PITA is new and important. The fever rates found in this study (about 45% for PITA and 10% for traditional) are higher than some previous estimates, which might be because this study specifically looked for and tracked fevers very carefully.

This study has several limitations that readers should understand. First, it’s relatively small with only 82 children, so the results might be different if a larger group was studied. Second, it was done at only one hospital, so results might vary in other places with different equipment or surgical teams. Third, the study only followed children for one week after surgery, so we don’t know if fever differences persist longer. Fourth, the two groups might have had some differences we don’t know about that could affect fever risk. Finally, the study didn’t investigate why PITA causes more fevers—it just showed that it does—so we don’t fully understand the mechanism.

The Bottom Line

If your child needs tonsil or adenoid surgery, discuss both surgical options with your doctor. The newer PITA technique appears to cause more fevers but offers benefits like less pain and faster return to normal eating. Have a plan to monitor your child’s temperature after surgery and know the signs of concerning fevers. Keep your doctor’s contact information handy and don’t hesitate to call if you’re worried. The evidence suggests fevers from PITA are manageable with proper monitoring and care, but this is a conversation to have with your surgical team.

Parents of children who need tonsil or adenoid surgery should care about this research. Children with recurrent throat infections, sleep apnea, or breathing problems are most likely to need this surgery. Doctors performing tonsil surgery should also be aware of these findings to properly counsel families. This research is less relevant for adults, as tonsil surgery is much less common in adults and may have different outcomes.

Fevers typically develop within the first few days after surgery and usually resolve within one week. Most children who develop fevers after PITA will experience them in the first 3-5 days. Pain improvement and return to normal eating typically happen within the first week for both techniques. Long-term benefits like reduced throat infections (the reason for surgery) take weeks to months to fully appear.

Want to Apply This Research?

  • Track your child’s temperature twice daily (morning and evening) for 7 days after surgery, recording the exact temperature and time. Also track pain level daily using a simple 0-10 scale and note when your child returns to eating solid foods. This data helps you spot patterns and provides useful information if you need to contact your doctor.
  • Set daily reminders to check your child’s temperature at the same times each day. Create a simple chart or use the app to log temperatures, pain levels, and diet changes. This keeps you organized and helps you notice if fever is getting worse or if your child is improving faster than expected.
  • Use the app to set alerts if temperature exceeds 101°F (38.3°C) or if pain levels don’t improve after 3 days. Track trends over the full week to see if your child is recovering as expected. Share this data with your doctor at follow-up visits to help them understand your child’s recovery and adjust care if needed.

This research describes findings from a single study of 82 children at one hospital. While the results are interesting, they should not replace advice from your child’s doctor. Every child is different, and your surgeon can best advise you on which technique is right for your child based on their specific situation. If your child develops a fever after surgery, contact your doctor immediately rather than relying solely on this information. Fevers can sometimes indicate serious complications that need medical attention. This summary is for educational purposes and not a substitute for professional medical advice.