Tonsillectomy: What to Expect
Read on to learn more about the risks, recovery, and reasons for a tonsillectomy.
One common reason for a tonsillectomy is recurring tonsillitis, which occurs when your tonsils become inflamed due to an infection. Your tonsils are part of your immune system, producing antibodies to remove germs that you breathe in. They can become enlarged or infected, causing various health problems.
The American Academy of Family Physicians (AAFP) has endorsed guidelines about tonsillectomy developed by the American Academy of Otolaryngology — Head and Neck Surgery (AAO-HNS). AAO-HNS defines tonsillitis as recurrent if it has occurred:
- seven or more times in the past year
- at least five times per year for the past 2 years
- at least three times per year for the past 3 years
In addition to the above criteria, each infection must be accompanied by a sore throat and have one of the following characteristics:
- a temperature above 100.9°F (38.3°C)
- swollen lymph nodes
- fluid secretion from the tonsils
- a positive test for strep throat, a bacterial infection
If tonsillitis meets these criteria, your doctor may recommend a tonsillectomy.
Another common reason for a tonsillectomy is sleep-disordered breathing, which means that your breathing and sleep patterns are disrupted by partial or complete obstruction of your airways.
Doctors may perform an adenoidectomy, or surgery to remove the adenoids, at the same time as a tonsillectomy. The adenoids are located in the back of the nasal cavity. Both tonsils and adenoids can become inflamed and cause infections, so it is common for doctors to take them out simultaneously.
In rare cases, a tonsillectomy may be used to treat tonsil cancer.
To prepare for a tonsillectomy, your doctor may ask you to discontinue taking certain medications for a period of time before the surgery. You will likely also need to fast beforehand.
Doctors typically perform tonsillectomies in an outpatient setting. You will be under general anesthesia during the procedure.
Doctors can use two techniques when performing a tonsillectomy:
- Extracapsular: This means that both of the tonsils are completely removed.
- Intracapsular: This means that some tissue may be left behind.
These techniques can be further subdivided into “hot” and “cold” categories.
Doctors can perform a hot tonsillectomy in a number of ways, including:
- Electrocautery: This procedure burns off tonsil tissue, which helps reduce blood loss by sealing the blood vessels.
- Radiofrequency ablation: This procedure use radiofrequency energy to destroy tonsil tissue.
- Harmonic scalpel: This procedure uses hot ultrasonic energy to vibrate a special blade. The blade cuts tonsil tissues and stops bleeding.
- Microdebrider: This procedure reduces the size of the tonsil with a rotary shaving device hooked up to suction.
For a cold tonsillectomy, doctors remove the tonsils with a scalpel. Although this has been the traditional method in the past and is associated with less pain after the surgery, it has become less common due to bleeding risks and advances in hot techniques.
Otolaryngologists, or ear, nose, and throat specialists, typically perform tonsillectomies. If your child needs a tonsillectomy, a pediatric otolaryngologist can perform the surgery.
One of the most common complications of a tonsillectomy is pain. The pain can cause difficulty eating and drinking, which can lead to dehydration. It is important to stay hydrated after surgery.
Bleeding can also occur after the procedure. A study from 2009–2013 showed that 2.8% of over 100,000 children had to go back to the doctor because of bleeding after a tonsillectomy. The bleeding may be more severe at night and in people with bleeding disorders.
A study of 1,920 children who underwent intracapsular tonsillectomies found that other risk factors may increase the chance of bleeding, including:
Some additional complications include:
The outlook for people who have had a tonsillectomy is generally good. Recovery from the procedure typically takes around 1–2 weeks if there are no major complications.
It is important to note that if you had a tonsillectomy to help correct sleep-disordered breathing, you could still experience some sleep and breathing problems and may need further treatment.
Below are some commonly asked questions about tonsillectomies. Dr. Nicole Aaronson provided the answers to these questions.
Do you get sick more without tonsils?
Studies have not shown that a tonsillectomy will increase your chances of getting sick. Strep throat infections after a tonsillectomy are less common, and when they do occur, they tend to be less severe.
Can tonsils grow back?
Tonsils that are completely removed through an extracapsular tonsillectomy should not grow back. If only part of the tonsil was removed, such as in an intracapsular tonsillectomy, there is a chance that the tonsil could grow back. In most cases, regrowing a tonsil is not enough to cause a recurrence of infection.