Large tonsils decrease the upper airways and cause oral breathing in children. If oral breathing persists, it leads to muscular and postural alterations, which, in turn cause dentoskeletal changes. In Sweden 6% of all children, have tonsil surgery performed. The indications are usually recurrent tonsillitis or severe snoring and/or sleep apneoa. Oral motor dysfunction including swallowing problems , disordered speech and aberrant dentofacial growth are less recognized problems as indications for treatment. We report results from a project aiming at comparing oral motor function and speech in children trated with two different  surgical methods, tonsillectomy (TE) and partial tonsil resection, tonsillotomy (TT). 67 children aged 4-5 years old on ordinary waiting list for tonsil surgery were randomized to either TE or TT. They were assessed with the Swedish version of Nordic Orofacial Test (NOT-S) and a Swedish phonological test. A voice recording was also made. The assessment was repeated 6 months after surgery. The results were compared to a control group without tonsil problems. No significant differences were found between the children operated with TE or TT. Both groups performed significantly better on the oral motor test at the postoperative assessment, and voice quality had improved. However, compared to the control group, the children with enlarged tonsils had a delay in phonological development, preoperatively that remained at the 6-month postoperative control