Tonsillectomy
What are the tonsils?
The tonsils are two small glands in the throat. Their role is to protect the immune system in early childhood. After the age of three their role is significantly reduced and they usually shrink.
The human body can fight infections even without the presence of tonsils.
When should they be removed?
They are usually removed if they cause recurrent episodes of tonsillitis. Another reason for removing them is throat obstruction due to enlargement causing breathing problems. In certain cases tonsils are so big in children that they cause breathing problems during sleep.
A peritonsillar abscess is a swelling arising in the area next to the tonsil due to infection (tonsillitis). Individuals that suffered a peritonsillar abscess usually decide to have a tonsillectomy in order to avoid future recurrence of the problem.
Also, tonsils are removed and biopsied if there is any clinical suspicion of malignancy (cancer). This is usually suspected if there is a rapid growth in the size of the tonsil, ulceration or haemorrhage. Tonsillar malignancy is however extremely rare.
What happens before the operation?
Inform your doctor in case you or your child are suffering from a cold as the operation might need to be postponed until you recover. It is also important that your doctor knows if you have regualar bruises or a family history of haematological problems.
How is the operation performed?
The operation takes place under a general anaesthetic. The tonsils are removed through the mouth and the bleeding is stopped. The operation lasts approximately 30 minutes.
How long am I or my child will be spending in the hospital?
Usually the hospital stay is overnight. Occasionally the operation can be done as a daycase.
What are the possible complications?
Tonsillectomy is usually a safe operation but every operation entails some risks. The commonest risk is haemorrhage. Generally speaking approximately 2 in 100 children will suffer postoperative haemorrhage and will need to return to hospital and one of these children will need to go back to the operating theatre to have the haemorrhage arrested. As far as adults is concerned, 5 out of 100 will suffer postoperative haemorrhage and will need to return to hospital but only 1 in 100 will need to go back to the operating theatre.
What happens after the operation?
Some children might suffer nausea and vomiting the first few hours after the operation but with appropriate medication they return soon back to normality.
The throat will be sore for about 7 days.
The use of regular painkillers is very important for this period of time.
Avoid taking aspirin as this can lead to haemorrhage.
Normal daily diet and lots of fluid are also very important. Chewing a gum can help. Avoid spicy food.
Another thing that can happen is ear-ache. This is very normal and temporary. It is due to a connection of nerves in the throat and ears.
Your throat or your child’s throat will be covered with a white slough. This is also normal and is due to wound healing.
Adults as well as children usually need 10-14 days off work or school. Home rest away from crowds and smoke is mandatory.
Haemorrhage can be serious!
If you or your child experience throat haemorrhage you have to contact your doctor immediately, or rush to the Accident and Emergency department.