Tonsillectomy

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Tonsillectomy

Tonsillectomy is the surgical removal of the tonsils. The tonsils are two pads of glandular (lymphatic) tissue, one situated each side of the back of the throat. The tonsils are relatively small in the first year of life and increase in size as a child grows older. They are usually at their largest between the ages of four and seven years. The role of these pads is to help provide a defence against infection which, in this case, enters through the nose or mouth. Tonsils also help in the production of antibodies to fight the infection more effectively.

Problems associated with Tonsillitis

Tonsils are prone to inflammation and enlargement. This can lead to a condition called tonsillitis. If these attacks become frequent and severe, or cause complications, your doctor might suggest an operation. Some reasons which suggest that an operation should be carried out include:

Recurrent bouts of tonsillitis accompanied by pain, discomfort and high temperature
Chronic tonsillitis that doesn't clear up with antibiotics
Frequent ear infections associated with tonsillitis
Breathing difficulties due to enlarged tonsils
Abscesses forming in the throat (peri-tonsillar abscesses or 'quinsy')
A child failing to thrive because of difficulty in swallowing due to frequent infection and enlargement of the tonsils

Medical Issues to Consider

Your doctor will give you a complete physical check-up. The tonsil pad has a large blood supply, and special note will be taken whether you have any abnormal bleeding tendencies. Your doctor will check to see if your tonsils are actively inflamed and, if so, will prescribe antibiotics for a few weeks to control the infection prior to surgery.

Operation Procedure

A tonsillectomy is performed under general anaesthesia. The patient's mouth is propped open and the tonsils are clamped with special instruments. The glandular tissue is contained inside a 'skin lining' - this lining is cut using scalpel, scissors, laser or an electric current (electrocautery). The tonsils are then removed. Each tonsil pad has a substantial blood supply, so electrocautery is often used to fuse the blood vessels and reduce the risk of haemorrhage.

Immediately after the Operation

After the operation you can expect:

When you wake up, you will be lying on your side - this is to prevent choking should any bleeding occur from the tonsil pad.
A sore throat.
Painkilling injections, if necessary.
The nursing staff will observe you frequently to check your pulse, blood pressure, breathing rate, and check your throat for any signs of bleeding.
For the first four hours after theatre, you will probably not be allowed to have any food or liquids.
You may find it difficult to eat or drink but you will be encouraged to do so - the more often you use your throat, the better.
You can expect a hospital stay of just one day or so.

Taking Care of Yourself at Home

Be guided by your doctor but general suggestions include:

Don't smoke.
Avoid vigorous exercise immediately after the operation.
Usually, you should have a week or so at home before returning to work or school.
Avoid crowded, enclosed areas (such as cinemas) for at least one week, to reduce the risk of infection.
Your sore throat may last for two to three weeks, but try to get back to your normal diet as soon as possible - avoid sticking to a jelly and ice cream diet.
Some foods can cause irritation and pain - avoid sour drinks (such as citrus fruit juices), spicy foods and roughly textured foods for about 10 days or so.
Avoid taking aspirin, since this painkilling drug can exacerbate bleeding. Only take those painkillers recommended by your doctor or surgeon.