Tonsils are two oval-shaped glands, on each side of the back of the throat. They are the first line of defence against viruses and bacteria that enter the mouth.
Tonsillectomies were commonly performed to treat inflammations and infections of the tonsils (tonsillitis). However, things are very different these days. Tonsillectomies are usually performed to treat sleep-disordered breathing, but, may still be performed for tonsillitis where there is no response to other treatments. It may also be needed to treat breathing and other problems related to enlarged tonsils.
Why do I need a Tonsillectomy?
A tonsillectomy is performed for various complaints, including:
- Chronic, recurrent or severe tonsillitis
- Enlarged tonsils
- Bleeding tonsils
- Other rare disorders of the tonsils
Tonsillitis is the infection and inflammation of the tonsils. It is commonly found amongst children between preschool age and the mid-teen years. The tonsil immune system function reduces after puberty, possibly accounting for the rare cases of tonsillitis in adults.
A tonsillectomy is recommended if it is caused by a bacterial infection that does not resolve with antibiotic treatment or if an infection results in the collection of pus behind the tonsil that doesn’t improve with drug treatment or after a drainage procedure.
Common complaints associated with enlarged tonsils include:
- Difficulty breathing
- Disrupted breathing while sleeping (Obstructive Sleep Apnoea)
What happens during the procedure?
A Tonsillectomy is usually considered an outpatient procedure. This means that patients are generally allowed to go home on the day of the surgery.
The procedure is performed under general anaesthesia, hence, there will be no pain or awareness felt by the patient.
The patient’s mouth would be kept open with the help of a gag. The surgeon would then use cold instruments (steel instruments) to cut out the tonsils on each side. The wound would be packed, and the patient reversed from anaesthesia. The entire procedure takes around 20-30 mins.
Post-Operative Management
Post-operatively, patients could experience moderate pain in the throat, pain in the ears, neck or jaw, mild fever, nausea and vomiting, bad breath, feeling of an object being stuck in the throat and swelling of the tongue or throat.
What are the risks of a Tonsillectomy?
Just like any other surgery, Tonsillectomies involve a certain amount of risk:
- Reaction to anaesthesia: For any case involving general anaesthesia, there is a certain element of risk. However, this risk is minimized by the careful monitoring of the anaesthetist.
- Swelling: The tongue and soft roof of the mouth could swell up, causing breathing problems. This particularly could happen after surgery.
- Bleeding during surgery: In very rare cases, excessive bleeding could occur during surgery. This could require additional treatment and could increase the patient’s stay.
- Bleeding post-operatively: Bleeding could occur in the post-operative healing phase if the scab from the wound gets dislodged too soon.
- Infection: The local wound could get infected. However, this is easily treatable with medication.