This article is on Tonsillectomy, a common surgical procedure in Otolaryngology. It is intended to help inform patients, relatives of patients and health professionals. The information in the grey boxes is more technical and intended more for Health professionals that are reading this article

 

What are Tonsils?

Tonsils are found at the back of the mouth and are part of the immune system. We have two tonsils, one on each side and they vary in size.

 

What is a Tonsillectomy?

Tonsillectomy is an operation to remove the tonsils. It is completed under a General Anaesthetic (an Anaesthetist will explain to you how this process will happen). In children it is common to also remove the adenoids at the same time. (Refer to Adenoidectomy)

 

What are the indications for a Tonsillectomy?

The indications for surgery are different between children and adults. For children tonsils are usually removed due to obstructive sleep apnoea or recurrent episodes of Tonsillitis.

For adults recurrent tonsillitis and suspicion for cancer are the main reasons for surgery

 

How is it diagnosed?

Diagnosis is made through a combination of symptoms, examination of the nose and scans of the sinuses. In some, but not all CRS cases, “polyps” are seen inside the nose.

Diagnostic Criteria:
– 2 or more of the 4 main symptoms for >12 weeks AND
– Evidence of mucosal inflammation
– Direct visualisation (Nasal enodoscopy)

 

What happens before surgery?

You cannot eat or drink anything from 6 hours before your surgery. The anaesthetist will see you either in clinic days before the operation or on the day of surgery.

You may be asked to have routine blood tests taken prior to your surgery. If you take regular medication, some of them, in particular blood thinners may need to be stopped prior to your surgery.

 

How long is the surgery?

The operation will take around 30 minutes to complete. But the entire process which includes pre-operation checks, anaesthesia and recovery can take several hours

 

What are the risks?

Your ENT Surgeon will explain all the risks of surgery and answer any questions during your consultation.

Bleeding is the main risk of a Tonsillectomy. Bleeding immediately after surgery is rare, but the risk of bleeding is there for approximately 2 weeks. If there is any bleeding or concerns after surgery, please seek urgent medical review.

The procedure is painful and regular pain relief should be taken in the first 7-10 days. Pain in the throat after the operation can often increase before getting better.

 

How long is the recovery?

Patients can usually go home the same day or spend one night in hospital after the operation. This will depend on the indication for surgery, patient age, patient co-morbidities and how far home is from hospital.

Expect to spend 1-2 weeks at home before returning to school or work. Children who return to school after 1 week must inform their school of their recent surgery and the potential risk for bleeding.

There are no dietary restrictions after the operation but drink plenty of fluids even if you do not feel like eating.

 

Further reading:

1. Tonsillectomy – Mayoclinic.org
2. Tonsillectomy and adenotonsillectomy – Clevelandclinic.org

 

References:
1. Gibber M. Tonsillectomy in adults. 2020. UpToDate.
2. Paradise J. Wald E. Tonsillectomy and/or adenoidectomy in children: Indications and contraindications. 2019. UpToDate
3. Busaba N. Doron S. Tonsillectomy in adults: Indications. 2019. UpToDate

 

Author + Affiliation:
Dr Johnny Wu, Department of Otolaryngology, Waikato Hospital.
Reviewed by Dr Andrew Wood, Otolaryngologist, Waikato Hospital

Date of Publication +/- Review:
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