Tonsillectomy
Why do we take out Tonsils?
Although the tonsils are made of lymphoid tissue that is part of the body's defence system they can be a source of recurrent infections giving rise to frequent sore throats. If these are frequent and severe enough to affect a child or parent's quality of life, then removing them is a reasonable decision.
The tonsils may also enlarge and cause problems with breathing and swallowing. Children may have trouble with breathing at night and this may affect their quality of sleep (Obstructive sleep apnoea). Some children with large tonsils have an increased sensitivity to swallowing harder textured food such as pieces of apple, pear and meat and may gag or choke on such types of food.
When is the right age to take out tonsils?
There is no absolute minimum limit. Most children with recurrent tonsillitis are generally older. Children with Obstructive Sleep Apnoea usually present young and often have surgery at around 2 years of age.
How do you remove tonsils?
A gag is inserted to open the mouth. The tissue overlying tonsil incised and the tonsil dissected away from its bed using fine bipolar diathermy forceps. The procedure takes between 15 - 20 minutes with the whole operation lasting 30 minutes. The surgery is often combined with an adenoidectomy.
What to expect after the operation?
Pain
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The first 3-4 days are not too bad but the pain becomes worse on the 5th to 7th days.
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It is essential to have a structured regine of pain relief and regular Paracetomol alternating with Neurofen every 3 hours is recommended.
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For the first 7 days it is important to do this even during the night. Antibiotics are usually given as they help recovery to normal eating.
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It is a good idea to have something to eat about 20 minutes after giving the pain killers.
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Where the tonsils were, looks white. This is the normal healing process and does not mean that there is an infection.
Ear ache
This is very common after surgery and happens because of referred pain the same nerve supplies the tonsil as well as the ear.
Voice change
Parents often find that their child's voice becomes higher after surgery. This is simply a result of the muscles in the throat contracting to minimise pain. It is a temporary symptom but may take a few weeks to fully recover.
Bleeding after surgery
The surgery itself is relatively bloodles. Bleeding occurs in about 1 - 3% of patients and usually happens at about 5-7 days after surgery. It is thought to be related to dehydration and possibly secondary infection. Immediate attendance to your nearest accident and emergency department is essential if this occurs.
Severe pain
A slow return to oral intake can lead to persistent pain. Readmission to hospital for rehydration and antibiotics for 1 - 2 days may be required.
What foods are best?
The best types of foods are soft textured foods. Bread, pasta and yoghurt are usually the preferred foods. Citric type foods sting and are best avoided. Ice lollies and ice cream usually go down well. As it is easy to become dehydrated it is important to have lots of fluids. The key to recovery is frequent swallowing which cleans the tonsil beds.
Will taking out my tonsils increase my chance of getting infections?
- There is no evidence that adenotonsillectomy compromises the immune system.
Why do I still get sore throats even though I had my tonsils removed years ago?
- Tonsillectomy will only prevent tonsillitis. Recurrent viral and bacterial infections of the throat (pharyngitis) may still occur.