Tonsillectomy

Overview

Tonsillectomy, the surgical removal of the tonsils situated at the back of the throat, was traditionally used to address tonsillitis but is now predominantly employed for sleep-disordered breathing. It may also be recommended in cases of frequent tonsillitis or when other treatments are ineffective. Additionally, this procedure can address breathing difficulties associated with enlarged tonsils and rare tonsil diseases. Recovery typically takes around 10 days to two weeks.

Reasons for undergoing the procedure

Reasons for Tonsillectomy

• Recurrent tonsillitis: Tonsillitis, characterized by inflammation and infection of the tonsils, can be chronic or severe. A tonsillectomy is often recommended to address recurring or severe cases of tonsillitis, which can disrupt daily life and pose health risks.
• Complications of enlarged tonsils: Enlarged tonsils can lead to various issues, including difficulty breathing and obstructive sleep apnea. Tonsillectomy is an option to alleviate these complications.
• Bleeding of the tonsils: Persistent or recurring bleeding from the tonsils may necessitate a tonsillectomy to prevent further complications.
• Other rare diseases of the tonsils: In rare cases, conditions such as malignancy or severe bad breath related to tonsil debris may require surgical intervention.
• Function of tonsils and vulnerability to infection: Tonsils serve as the body’s initial defense against oral bacteria and viruses. While their immune function declines after puberty, they remain susceptible to infections, leading to inflammation and potential complications.

When Tonsillectomy is Recommended:

• Inadequate response to antibiotic treatment for bacterial infections.
• Failure of treatment for tonsillar abscess, which may require drainage or other interventions.
• When enlarged tonsils cause breathing difficulties or obstructive sleep apnea.

Risks

Complications can occur even if they are rare. Some possible risks include:

• Infection.
• Excessive bleeding during the procedure or during the recovery.
• Swelling of the tongue or the soft roof mouth
• Reaction to anesthesia.

Before the procedure

Prior to surgery, nurses typically administer a pre-surgery checklist, which includes verifying the patient’s name and the purpose of the surgery to ensure safety. Healthcare providers conduct routine health assessments to ascertain the patient’s suitability for the procedure, often requesting blood tests. Detailed preoperative instructions are provided to patients, and adherence to these guidelines is strongly advised for optimal preparation.

During the procedure

During a tonsillectomy procedure, various methods may be employed by surgeons. These include electrocautery, which uses heat to remove the tonsils and control bleeding, cold knife dissection involving a traditional scalpel followed by cauterization or sutures, and snare tonsillectomy utilizing a specialized instrument to clamp and remove the tonsils to minimize bleeding. Additionally, techniques such as the harmonic scalpel, radiofrequency ablation, carbon dioxide lasers, or microdebriders may be utilized. Each method aims to efficiently remove the tonsils while minimizing bleeding and discomfort for the patient.

Typically, a tonsillectomy procedure lasts around 20 to 30 minutes, though this duration may vary depending on individual circumstances. While some cases might necessitate a longer surgical time, the primary objective remains to safely remove the tonsils with precision while ensuring the patient’s comfort and well-being throughout the procedure.

After the procedure

Following your tonsillectomy, you’ll be moved to a recovery area where your medical team will monitor your vital signs to ensure there are no complications. Typically performed as an outpatient procedure, allowing you to return home on the same day, complications are uncommon; however, if any arise, your healthcare provider may opt to keep you overnight in the hospital for observation and continued care.

Outcome

After a tonsillectomy, recovery typically takes about two weeks, but varies based on factors like surgery type and individual healing capacity.

• Days 1-2: Throat pain, low-grade fever, fatigue, bad breath, difficulty speaking, throat swelling feeling.
• Days 3-5: Continued sore throat, worsening pain, fatigue.
• Days 5-10: Scabbing, mild bleeding as scabs fall off.

During recovery, focus on fluids and soft, cool foods like water, ice cream, smoothies, yogurt, and avoid hard or spicy foods.

Plan to take at least 10 days off work or school to reduce infection risk. Call your healthcare provider if you experience excessive bleeding, breathing difficulties, worsening pain, nausea, signs of dehydration, or a persistent fever over 101°F (38.3°C).