Tonsillectomy: Indications and Risks

Tonsils area pair of oval-shaped tissue present in the back of your throat, one on each side, which house cells responsible for fighting off microbes. Tonsillectomy, a procedure to remove these pairs of tissue, is the second most common surgery performed on children in the US. Annually about half a million children get their tonsils removed. Adults may also need to get their tonsils removed as a treatment for sleeping problems or other rare diseases of the tonsils.

Types of Tonsillectomy Procedure

Tonsillectomy is done under general anaesthesia; hence you will be unconscious during the whole procedure and won’t feel any pain while your surgeon is removing the tonsils. There are multiple ways in which the surgeon the can remove the tonsils:

• Steel dissection: your surgeon will use a scalpel to cut off the tonsils and the bleeding will be stopped with the help of sutures or electrocautery.
• Electrocautery: extreme heat is used to cut through the tissue, this helps in controlling the bleeding simultaneously.
• Harmonic scalpel: using ultrasonic sound waves your surgeon cuts through the tissue and prevents bleeding at the same time.
• Laser dissection: using laser your surgeon dissects through the tissue cutting it and preventing bleeds.

The procedure is completed about 20-30 minutes unless there are complications.

Indications for Tonsillectomy

Tonsillectomy is suggested to a patient to:

• Prevent obstructive sleep apnoea: enlarged tonsils may interfere with normal breathing and lead to disrupted breathing during sleep. Tonsillectomy may help in reducing this difficulty in breathing during sleep.
• Prevent frequent episodes of tonsillitis: recurrent infections in the tonsils may damage them and make them fertile ground for infectious microbes, removing the damaged tonsils may help in reducing the frequency of sore throats due to tonsillitis.
• Help patients with difficulty in swallowing and breathing because of an increase in size of the tonsils.
• Treat collection of pus behind the tonsils ( peritonsillar abscess)
• Treat a cancer of the tonsils

Preparation for Tonsillectomy

To prepare for the surgery your doctor will like to get a set of routine investigations of the blood to check for your fitness for the surgery. Inform your doctor if you have a bleeding disorder or have a family history of one. Past reaction to any anaesthetics is information that your doctor would like to know about.

Before the surgery your doctor will ask you not have anything after midnight the day before your surgery. You will also be asked to stop any blood thinning medication in preparation for your surgery.

Risks of Tonsillectomy

Tonsillectomy can be complicated by the occurrence of:

• Allergic reaction to the anaesthetic used
• Excessive bleeding during the surgery
• Bleeding during the recovery period
• Infection of the wound site
• Swelling of the tongue and back of throat leading to difficulty in breathing.

Recovery after Tonsillectomy

The recommended recover period is about two weeks. After the surgery, unless there are complications, you will be allowed to go home the same day. It is advisable to arrange for someone to drive you home. Your doctor will advise you to ingest a liquid diet initially. You will be advised to avoid spicy and acidic food and crunchy hard food to prevent injury to the site of surgery. Drink plenty of fluids to prevent dehydration.

Pain is one of the most common complain after the surgery. Your doctor will prescribe pain medication to control this complain. If you have fever or bleeding from the wound site or difficulty in breathing you are advised to contact your doctor immediately.

Resources

• American Society of Otolaryngology