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Tonsillectomy

A tonsillectomy involves using surgery to remove the tonsils. The tonsils are two pads of tissue located in the back of the throat. There is one tonsil on each side of the throat paired with similar tissue located in the back of the nasal cavity. These smaller pieces of tissue are called the adenoids and they are sometimes removed along with the tonsils.

Tonsillectomies used to be very commonly done on children who had a lot of inflammation and infection of the tonsils. Since patients with a tonsillectomy have problems with sleep apnea and sleep-disordered conditions, the tonsils need to be removed when they were very enlarged. Now antibiotics can help many of these patients with chronic tonsillitis. It is still done for those people that have sleep problems because of the enlargement of the tonsils.

Tonsillectomies can also be done on those who have chronic tonsillitis or who have breathing problems related to large tonsils. The procedure is usually done on children who recover well. The average recovery time is 10-14 days.

Doctor�s do a tonsillectomy for the following reasons :

• Complications stemming from enlarged tonsils.
• Chronic or severe tonsillitis.
• Rare tonsil-related diseases.

The tonsils have the purpose of harboring certain white blood cells that together act as the first line of defense against bacteria and viruses that come into our system through the mouth. This makes the organ particularly at risk for inflammation and infection. This �immune system activity� is most active in children so children are more likely to get tonsillitis, which is tonsillar inflammation and infection. Children have the least prior exposure to pathogens and are therefore more likely to get infections.

A tonsillectomy if a person has many episodes of tonsillitis. The definition includes the following :

• Having more than 7 episodes per year. .
• Having more than 5 episodes per year for the last two years. .
• Having more than 3 episodes per year for the last three years. .
• Having a bacterial tonsillitis that does not get better with antibiotics.
• Having a tonsillar abscess that doesn�t clear after an attempt to drain it. .
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If the tonsils are enlarged and are not treated with a tonsillectomy, the following complications can happen:

• Problems breathing due to upper airway obstruction.
• Difficulty swallowing.
• Sleep apnea from upper airway obstruction.
• Tonsillar bleeding from surface vessels.

There are risks and complications of having a tonsillectomy. These complications include the following :

• You can have a reaction to anesthesia. Short term problems include nausea, headache, muscle soreness, nausea and vomiting. Long term problems are not common but a bad reaction can lead to death. .
• Local swelling can happen. This can involve the roof of the mouth, the tongue and other tissues so there can be upper airway obstruction and breathing problems. It is worse in the first few hours following surgery. .
• Intraoperative bleeding. There can be bleeding during the surgery that gets out of control and requires a longer surgery and a longer stay at the hospital. .
• Postoperative bleeding. This can occur following surgery if the scab that covers the tonsillar fossa becomes dislodged. The patient may need emergency measures, including the possibility of emergency surgery. If this cannot happen quickly, the patient may die. .
• Infection. The area is already infected in most cases and can flare up after surgery with a bacterial infection. .

In today�s time, tonsillectomies are done as outpatients. Patients come in early to prepare for surgery and can return home by evening. If the child is young or the surgery complicated, there is often an overnight stay. The procedure is done under general anesthesia and takes about half an hour to accomplish. There will be pain in the throat, jaws, neck or ears following the procedure for which oral or injectable pain medication is used. This is treated with oral medications to control pain and inflammation. Expect the possibility of complications and rest as much as possible in order to reduce the chance of bleeding or other complications.