Tonsillectomy is a surgical procedure to remove the tonsils. Tonsils are the two small glands located around the back of the mouth and nasal cavity. Tonsils protect the body by capturing the germs from the mouth and preventing them from entering the body.
There are three types of tonsils: palatine, adenoids, and lingual. However, sometimes the tonsils can get infected and can cause tonsillitis. This makes the tonsils swell, making it difficult to swallow food, with fever and more.
Frequent tonsillitis may be one of the reasons for performing tonsillectomy surgery. Moreover, the surgery can also be performed to remove the enlarged tonsil causing breathing problems like snoring or sleep apnea. Tonsillectomy is one of the most common surgeries done on kids and teens compared to adults. The recovery period after tonsillectomy is usually 10 days to 2 weeks, depending on the type of surgery performed and other conditions.
Who is best candidate for tonsillectomy?
People who have infected or swollen tonsils for a prolonged period are usually the best candidates for tonsillectomy surgery. In some cases, the tonsils are so big that they block the airway and makes it hard for the person to breathe properly. Your doctor may consider you a good candidate for tonsillectomy if you meet the following conditions:
- Recurring tonsil infections in the past year or five to seven for past two years
- Bacterial tonsillitis that won’t go away with other treatments
- A tonsillar abscess that does not go away with drug treatment
- Breathing problems due to swollen or enlarged tonsils
- Bleeding of tonsils
- Sleep apnea or pause in breathing during sleeping due to enlarged tonsils
- Cancer of the tonsils
Who should not consider a tonsillectomy?
Tonsillectomy is not recommended for children who are under 3 years of age. Moreover, the following reasons may not make you a good candidate for tonsillectomy:
- Misshapen mouth or an oral condition that makes it difficult to perform a surgery
- Bleeding disorder, anaemia, or any other chronic illness
- Unable to tolerate anesthesia
- Tonsillitis or tonsil infection occurs less than four times a year
Preparation before tonsillectomy
Your doctor will explain the whole procedure in great detail. They will ask if you take any medications, including over-the-counter drugs, herbs, and vitamins. The doctor may tell you to stop taking certain medicines before the surgery. They will ask about allergies along with the family history of any bleeding disorder and then give some instructions, including diet and alcohol restrictions. Apart from this, you may be asked to:
- Get a Medical evaluation
- Get a Physical examination
- Throat swab or CBC test
- Avoid taking anti-inflammatory drugs (such as aspirin) to avoid the risk of bleeding
- Your doctor will take photos to compare before and after results
Your doctor will ask you not to eat anything starting at midnight the night before the surgery. However, one can have some liquids, though it is always better to check with your doctor to see what is allowed to take before the surgery.
Tonsillectomy surgery is generally done as day care procedure, meaning that one can go home on the same day of the surgery. However, in some cases, the doctor may recommend an overnight stay if there are any complications. The whole surgery takes about an hour and is performed under general anaesthesia. The tonsillectomy surgery can be performed using different techniques. The most common ones are as follows:
Cold Knife Dissection
The surgeon removes the tonsils using a scalpel in this procedure. The surgeon dissects the tonsils and sutures the muscles to close them.
In this procedure, the surgeon burns the tonsillar tissues and cauterizes the area to stop bleeding. This technique is relatively common and can sometimes run the risk of injury to the surrounding tissues around the tonsil.
In this technique, the surgeon uses a medical device with ultrasonic energy to vibrate the blade at around 55,000 cycles per second. The tonsils are cur and coagulated simultaneously.
In this procedure, the surgeon uses a microdebrider, a rotary device that shaves the tissues away. It may be used to perform a partial tonsillectomy and is recommended for enlarged tonsils.
Bipolar Radiofrequency Ablation
An ionized saline layer is charged with radiofrequency waves in this procedure. The energy breaks the molecular bonds in the tissue and separates it without affecting the surrounding tissues.
A highly precise technique with minimal bleeding. Higher temperatures reached during laser surgery can potentially harm neighboring tissues. The only downside is the exceedingly high cost of laser surgery.
Coblator© Assisted TonsillectomyBy far the most accepted technique of tonsillectomy in the modern era worldwide. Negligible bleeding and relatively lesser post op pain makes this technique the preferred technique of 21st century. Post operative recovery phase is shorter and patient are able to get back to their routines sooner.
Side effects and complications of tonsillectomy
Tonsillectomy surgery is usually considered a safe procedure. However, there are some possible complications after the surgery. These may include:
- Mouth infection
- Pain in jaws
- Bleeding from mouth during recovery
- Reaction to anesthesia
Care after tonsillectomy
Patients can experience some pain after the tonsillectomy surgery. In some cases, there might be a sore throat after the surgery. One might also feel pain in the jaws, ears or neck after the surgery. In most cases, you will start walking the next day after the surgery. You can resume your daily strenuous activities two-three weeks after the surgery. Generally, recovery after tonsillectomy surgery can take a week or more. The doctor may recommend the following for a speedy recovery after the surgery:
- Taking medications for pain
- Suck on ice cubes and drink plenty of water and other clear fluids
- Drink smoothies and eat soft foods
- Limit any strenuous activity for at least two weeks
- Watch for signs of infections
- Take proper rest
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