Tonsils and Adenoids

What is a tonsillectomy?
A tonsillectomy is the removal of the tonsils that are at the back of the throat. At times during tonsillectomy, the adenoids are removed as well.

What are the tonsils (and adenoids) there for?
The tonsils and adenoids are part of the lymphatic system. Their role in the body is to protect you from infection by trapping germs that may enter through your nose or mouth.

If the tonsils (and adenoids) are part of the defense system, why are they then removed?
The tonsils (and adenoids) are only removed when they are misbehaving. It Is at this point, they are more of a problem than a help.

Is it then true that once the tonsils are removed, you are more susceptible to infections?
No it is not true at all that tonsil removal increases your chance of infections.

Is it true that tonsil removal worsen chest conditions like asthma?

Although this is controversial, recent studies show that this is not true at all. In fact, in the right circumstances, it actually improves the asthma control.

What are the indications for tonsillectomy?
1.     Frequent bouts of acute tonsillitis (inflammation of the tonsils).
2.     Chronic tonsillitis, consisting of persistent, moderate-to-severe throat pain.
3.     Abscess behind the tonsil.
4.     Sleep apnea (stopping or obstructing breathing at night due to enlarged tonsils or adenoids).
5.     One tonsil enlargement (suspicion of cancer).
These are the most common. There are some other rare indications. Please consult your specialist for details.

How are the tonsils removed?
There are many ways to remove the tonsils. They range from dissection (pealing) to laser. More recently, coblation tonsillectomy and thermal welding forceps technique have been devised. The ultimate outcome is very similar for any type of technique used. Please chat to your specialist for details.

Is the tonsillectomy painful?
Because the procedure is done under anaesthesia, tonsillectomy is not painful at all. However, after the procedure, pain is normal. Pain lasts typically 10 days, but ranges from 7 to 21 days. There is a period a few days after the procedure (5-8) that the pain temporarily worsens. This is normal and is due to the muscles stiffening.

I have been told that a tonsillectomy in adults is dangerous. Is this true?
Tonsillectomy in adults is no more dangerous than in children. It is however, more painful post operatively.

What are alternatives to tonsillectomy?
Tonsillitis may be treated with antibiotics.
Partial removal of tonsils (tonsillotomy) in the ENTs office is also an option in some people.
Surgery is only considered after you and your ENT have determined, based on the risks and benefits, that tonsillectomy is appropriate for you.

How do you prepare for the operation?
Avoid blood thinning medication such as aspirin or similar medication for at least 2 weeks.
On the day of the procedure, patients cannot have any food or milk for 6 hours prior to the scheduled time.
Only clear fluids are allowed up to 2 hours prior to the time.
Thereafter nothing should be had orally.

What is the post tonsillectomy recovery process?
Most children go home on the same day. Adults usually stay for one night in the hospital. Stay indoors for a few days and avoid any strenuous activity for at least two weeks. You will be given a post operative check up date, where your ENT will see how well you are doing.

What foods are best to eat after tonsillectomy?
It is best to establish a normal eating pattern postoperatively. There is no real limitation to what you can eat. Generally avoid excessively spicy, acidic, salty and hot food. Ice cream (except for those who get excessive mucous) is great because it fills your stomach (patients don’t eat too much post operatively and this does upset the stomach as they are on a lot of medication) and soothes the area. Toasted bread is recommended because it helps remove the scabs from the area. Please do not force the scabs off.

What is the yellow area at the back of the throat where the tonsils used to be?
That is the scab and is referred to as slough. It is normal and does not mean that there is an infection.

How do you control the pain?
Take the pain killers prescribed on time even if you are not having pain. Preventing the pain is easier than treating it after it has established. Eat and drink plenty to get the muscles moving.

Can the tonsils and adenoids come back after removal?
The adenoids can recur as they are never completely removed, only flattened. After the age of 8, they usually don’t come back.It is rare but possible for the tonsils to come back.

Ear,Nose and Throat Specialists