Tonsils

Tonsils produce certain types of white blood cells that fight disease. Therefore, it is assumed that the tonsils serve as the first line of protection of the immune system against bacteria and viruses that invade the mouth.

Inflamed Tonsils

This function can make them especially vulnerable to inflammation and infection and is more common in children. Unlike the immune system of an adult, a child’s system has had less exposure to bacteria and viruses and therefore has immunities to grow against them.

Tonsillectomy is a surgical operation that extracts all palatine tonsils entirely from the back of the throat. The treatment is primarily for chronic throat infections and obstructive sleep apnea (OSA) and other breathing problems due to enlarged tonsils.

Recovery time is typically at least 10 days to two weeks for a tonsillectomy.

Complications of enlarged tonsils

Complication encountered by enlarged tonsils are:

  • Breathing difficulties;
  • Disrupted respiration while sleeping;
  • Swallowing up difficulty;
  • Certain tonsil diseases;

Tonsillectomy can also be used for treating certain rare tonsil diseases or disorders, such as:

  • Cancerous tissue in a tonsil, or both;
  • Recurring leakage from blood vessels close to the tonsil surface;

In whom tonsillectomy is required?

In patients with:

  • Recurring tonsillitis, chronic or severe;
  • Enlarged tonsil complications;
  • Tonsils Bleeding;
  • Certain rare tonsil diseases;

How is a tonsillectomy done?

There are several ways a tonsillectomy can be performed. The procedure length is about 20 to 30 minutes and the patient is given general anesthesia. Generally, both the tonsils are removed, but in some cases, partial tonsillectomy also helps.

The technique is customized according to the needs of the patient. Some common techniques include:

  • Electrocautery: Using heat to remove the tonsils and avoid bleeding.
  • Dissection by cold knife (steel): Tonsils are cut with a scalpel. Bleeding is then stopped with electrocautery (extreme heat) or sutures.
  • Harmonic scalpel: Ultrasonic frequency vibrations are used for the treatment
  • Other approaches include using ablation techniques with radiofrequency, a carbon dioxide laser, and/or a microdebrider.

Risks

Tonsillectomy, like many other surgeries, has certain risks:

Aesthetic reaction: During surgery, medicine to help the patient sleep sometimes causes mild, short-term complications such as headache, nausea, vomiting, or muscle aches. Rarely late period complications are seen and one such rare condition is death due to anesthesia.

Swelling: In the initial few hours post-intervention, the patient can have swelling of tongue and soft palate which can cause breathing trouble.

Bleeding: Significant bleeding happens during surgery in rare cases, which needs further care and a longer stay in the hospital.

Healing time bleeding. Bleeding may occur during the healing process, particularly if the scab is dislodged from the wound too early.

Infection. Surgery will rarely lead to an infection which needs further care.

Before surgery

Prior to the surgery, all the instructions will be given on the preparation which will include:

  • Medications that are ongoing will be evaluated by the surgeon
  • Evaluation of adverse reactions to anesthesia
  • Evaluation of any bleeding disorders
  • Any known allergy or adverse reactions to medications

The surgeon will advise:

  • To stop any anticoagulant being used at least 2 weeks before the planned intervention
  • To keep nil by mouth for at least 8 hours 
  • On what to eat and what to avoid
  • About the recovery period and what is needed from the patient’s and relatives end

What you can expect

Tonsillectomy is normally performed as an ambulatory procedure. That is the patient is usually sent home the same day, additional hospital stay may be required only in case of occurrence of an adverse event.

During the surgery

The patient will be given general anesthesia and highly specialized surgical tools will be used for cutting the tonsils and stopping the bleeding to happen.

During recovery

Patients usually complain of pain post-tonsillectomy for which medications are prescribed. Patients are advised to have plenty of fluid intake after surgery. Initially, spicy, hard, and food causing pain or bleeding are avoided, generally served bland food and as per the tolerance and condition other foods are added.

Patients are advised to avoid performing any activities which are strenuous and to take adequate rest for at least 2 weeks post-surgery. 

Generally, within this time period, patients are able to get back to their normal activities.

When to see the doctor

In case of the patient is having bleeding, or has a high-grade fever (more than 101°F), or decreased fluid intake causing dehydration, or if the patient is experiencing weakness, headache, etc. or if the patient is having difficulty in breathing, or any other adverse event not mentioned elsewhere, then the patient should immediately contact the surgeon.