Please, choose your language

English | Français | Deutsch | Norsk

Tonsillectomy (surgical removal of the tonsils)

What are the tonsils?

Tonsils or palatinal tonsils
Tonsils or palatinal tonsils

Tonsils (or palatine tonsils) are masses of lymphatic tissue inside the mouth at the back of the throat. The tonsils are part of a lymphatic tissue ring (the so-called Waldeyer ring), which is located in the oral cavity and the pharynx. Being part of the immune system, this ring serves as our first line of defense against infections by acting as a biological filter station.

When is a tonsillectomy (surgical removal of the tonsils) recommended?

Acute tonsillitis is an infection of the tonsils which can cause them to swell. The symptoms include a sore throat, fever, troubles with swallowing, and enlargement of the lymph nodes around the neck. It is often caused by bacteria (streptococcus species). If you frequently suffer episodes of tonsillitis (reccurrent tonsillitis) a tonsillectomy might be necessary.

Chronic tonsillitis may lead to a permanent sore throat, bad breath, and long-term enlargement of the lymph nodes located in the neck. It might be the reason behind patchy or diffuse hair loss, joint complaints, skin rashes of uncertain origin, constant fatigue, permanent rise in body temperature or fever, and chronic urogenital inflammations. In these cases, surgery is strongly reommended.

You are also encouraged to undergo surgery if you have enlarged tonsils. Enlarged palatine tonsils may significantly narrow the throat, which may cause swallowing and breathing difficulties, and may contribute to snoring and tot he development of obstructive sleep apnea syndrome (OSAS).

You might wonder if your body will be able to fight off infections after the surgery. The answer is yes, sufficient amounts of lymphatic tissue will remain in the oral cavity and the pharynx (adenoid, lingual tonsils, etc.).

How is the surgery performed?

Tonsillectomy is the surgical removal of the tonsils, often performed in parallel with adenoidectomy. The procedure takes about 40 minutes, and is performed under general anesthesia, following the administration of antimicrobial agents to prevent infection at the site of the surgery.

There are several ways to remove the tonsils, the most common of which is called “dissection and snare” which involves the dissection of the tonsil along with its capsule. The tonsil is then lifted out of its bed, and ultimately removed with the help of a so-called tonsillar snare. The remaining tissue surface is cauterized, Other techniques, such as laser and coblation tonsillectomy are also used at our hospital. The main advantage of coblation is reduced bleeding and milder postoperative pain.

The tonsil reduction surgery is performed using laser or  radio-frequency procedure.

What are the risks and benefits of the surgery?

Risks

As with any surgery, there are certain risks associated with tonsillectomy, including infections and bleeding. The risk of bleeding is higher on days 5 to 7 after surgery, when scabs begin fall off.

You will receive a patient information sheet and an informed consent form which will provide you with detailed information regarding the risks of the operation, as well as what to expect before, during and after the procedure. By all means feel free to discuss the possible risks or any other concerns with your ENT surgeon before making a treatment decision.

There are certain risks associated with general anesthesia too, these will be explained to you on a separate information sheet. You will be required to sign a second informed consent form regarding anesthesia. You will also have some preoperative tests to ensure that these risks are reduced to a minimum.

It is important to call your surgeon immediately if you develop a fever, permanent nasal bleeding, blood spitting or vomiting, or a severe headache after your release from the hospital.

 

Benefits

Removal of the tonsils may reduce the frequency and severity of throat infections. It may also prevent the development of potentially serious complications of streptococcal pharyngitis and tonsillitis/rheumatic fever such as kidney, heart, joint or brain conditions. In the case of enlarged palatine tonsils, tonsillectomy will improve your breathing and your ability to swallow.

In addition, you can finally stop taking the antibiotics you previously needed to help fight infections caused by recurrent tonsillitis.

Am I a good candidate for tonsillectomy?

Tonsillitis and tonsillectomies are more common in children than adults. However, unless removed, tonsils may cause problems at any age. Your ENT (ear, nose and throat) surgeon will decide if surgery is necessary in your particular case based on your symptoms, medical history and a thorough physical examination. You will be asked to undergo some tests (blood test, ECG), and to see your anesthesiologist and internist before your operation. This is to ensure that your general health and physical condition allow a tonsillectomy under general anesthesia to be carried out safely.

All of our patients are asked to complete a detailed medical history form. It is important to fill out the questionnaire to the best of your knowledge because the answers you provide will help our surgeon decide whether you are eligible for tonsillectomy.

If you are taking blood thinners (medications that prevents blood clots from forming) your tonsils should not be removed.

How to prepare for the surgery?

  • Prepare a list of all of your symptoms and any known medical conditions, past illnesses and allergies, even if they seem unrelated to your current condition. For this purpose, you will be given a detailed form to be filled out, followed by a physical examination.
  • Be aware of any restrictions to adhere to prior to procedure. Your ENT surgeon will provide you with all the information you need to prepare for the diagnostic tests.
  • List all the drugs and medications you take, including vitamins and supplements
  • Ask a family member or friend to accompany you to your appointment and aks them to help you recall the information to be provided during your consultation.
  • Before your surgery you will receive a patient information sheet and an informed consent form which you will be requested to read carefully and sign. These documents will contain everything you need to know regarding preparation, the surgery itself and recovery.

What to expect after my tonsils have been removed?

It takes about 14 days to fully recover from the surgery.

You can expect to have moderate to intense pain (sore throat, ear pain) for seven to ten days. The pain can be significantly reduced by the use of oral pain killers.

You should only take medication approved by the ENT surgeon at our clinic. In order to ensure a safe and fast recovery follow your doctor’s recommendation at all times regarding post-operative care.

It is normal to feel a bit groggy and sleepy for about a day after surgery until the effect of general anesthesia wears off.

If there is no bleeding, you will be discharged on the first day after surgery. You will be advised to rest as much as possible for about two weeks, avoiding any intense physical activity due to an increased risk of bleeding at the site of surgery (nasal bleeding, blood spitting or vomiting). In case of bleeding you should call your surgeon immediately, and go to the closest emergency room.

It is important to drink plenty of fluids and eat a soft diet (only soft, pureed or easy-to-chew food) during the recovery period.

It is strongly recommended to avoid travelling by plane and to remain in the vicinity of a health care facility for two weeks following surgery.

Why is regular follow-up important?

The first follow-up appointment will take place a week after your operation. Your doctor will want to monitor how your recovery is progressing, checking for signs of infection and bleeding. In some cases a second follow-up exam might be necessary.