Tonsillectomy is a surgical procedure to remove the tonsils, which are located at the back of the throat. The tonsils are an important part of the human immune system, playing a role in protecting the body from infections, especially in childhood. However, chronic inflammation or other conditions can cause problems, requiring their removal. Tonsillectomy in adults is sometimes necessary when recurrent infections, sleep apnea, or other complications occur despite conservative treatment. While tonsillectomy is most often performed on children, it may also be required in adults for certain medical reasons. The frequency of this procedure has decreased in recent years due to improved treatment methods, but it remains one of the most frequently performed ENT surgeries.

When is a tonsillectomy necessary?

Tonsil removal may be necessary for the following conditions:

Chronic or recurrent tonsillitis 

If throat infections recur several times a year and are accompanied by severe pain, fever, and difficulty swallowing, this may be a reason for a tonsillectomy.

Sleep apnea

The tonsils can enlarge and cause breathing difficulties, leading to sleep apnea, a condition in which breathing briefly stops during sleep.

Tonsillogenic intoxication

Long-term inflammation of the tonsils can cause general intoxication of the body and a deterioration in overall health.

Tonsil abscess

In cases of purulent inflammation (peritonsillar abscess), the tonsils can become a source of infection, requiring their removal.

Suspected tumor

In rare cases, tumors in the tonsil area require a biopsy or complete tissue removal.

Preparing for surgery

Before performing a tonsillectomy, the doctor conducts a full examination of the patient and prescribes several tests to ensure there are no contraindications. Key preoperative tests include:

  • general blood and urine analysis;
  • coagulogram (blood clotting test);
  • ECG to rule out cardiovascular diseases.

The patient is also advised to stop taking medications that affect blood clotting, such as aspirin, and to avoid alcohol for several days before surgery. On the day of surgery, it is important to follow your doctor’s recommendations, including fasting before anesthesia.

Progress of the operation

Tonsillectomy can be performed using various methods:

Traditional method

The operation is performed using surgical instruments under general anesthesia. The doctor removes the tonsils with a scalpel or other instruments.

Laser tonsillectomy

This method uses a laser beam to destroy tonsil tissue and simultaneously coagulate blood vessels, reducing the risk of bleeding.

Radiowave tonsillectomy

This technology uses radio waves to destroy tonsil tissue while causing minimal damage to surrounding tissue.

Coblation

This method uses plasma radiation to remove the tonsils, minimizing postoperative pain and accelerating healing.

The surgery typically lasts approximately 30–45 minutes, and the patient is under general anesthesia. After the tonsils are removed, the wounds are left open to heal. The doctor monitors bleeding and, if necessary, performs vascular coagulation.

Postoperative period and recovery

After a tonsillectomy, the patient needs some time to recover. The first few hours after surgery, the patient remains in the hospital under observation by medical staff. In most cases, discharge occurs within 24 hours, unless complications arise. Basic recommendations after surgery:

Diet

In the first days after surgery, the patient is advised to eat liquid or soft foods (soups, porridge, yogurt). Hot, spicy, and acidic foods are avoided to avoid throat irritation.

Fluid regimen

Drinking plenty of fluids is important to prevent dehydration and speed healing. Avoid hot drinks and alcohol.

Pain

After surgery, a moderate sore throat is possible, possibly radiating to the ears. The doctor will prescribe painkillers to alleviate the pain. The pain may last up to 7-10 days.

Limit physical activity

It is recommended to avoid strenuous physical activity during the first week after surgery, as this may increase the risk of bleeding.

Oral hygiene

Rinsing the mouth with special antiseptic solutions is recommended a few days after surgery.

Full recovery usually takes about 2–3 weeks. It’s important to follow your doctor’s recommendations and report any changes in your condition (bleeding, fever, severe pain).

Possible complications

Although tonsillectomy is a relatively safe procedure, like any surgery, it can be associated with certain risks and complications. The most common complications include:

Bleeding

This is the most common complication, which can occur within the first 24 hours after surgery or a few days later. It is usually associated with injury to blood vessels during healing.

Infection

In rare cases, a wound infection may develop, requiring antibiotic therapy.

Pain

Pain after tonsillectomy can persist for up to 10 days, especially when swallowing. Pain medications are used to alleviate pain.

Difficulty swallowing

After surgery, the patient may experience temporary difficulty swallowing, which usually resolves within a few days.

Voice changes

Some patients experience changes in the timbre of their voice due to anatomical changes in the throat.

Tonsillectomy in children and adults: differences

Tonsillectomy in children and adults differs in several ways, depending on age. Children typically recover more quickly after surgery, and complications are less common. Adult patients may experience more severe pain, and their recovery may take longer. Additionally, adults are more likely to experience postoperative complications such as bleeding, and the recovery period may be longer due to age-related changes in tissues.

Alternatives to tonsillectomy

Tonsillectomy is a radical treatment method and is not always the only option. In some cases, doctors may recommend less invasive options:

Medication

Antibiotics, antiseptics, and immunostimulants can help with chronic tonsillitis, preventing the need for surgery.

Physiotherapy

Laser therapy, ultraviolet irradiation, and electrophoresis can be used to reduce tonsil inflammation and boost local immunity.

Cryotherapy 

Cold treatment of the tonsils helps reduce inflammation and partially destroy damaged tissue without completely removing it.

Conclusion

Tonsillectomy is an effective treatment for chronic tonsillitis, but the decision on the need for surgery should be based on a thorough assessment of the patient’s condition and medical history. Modern surgical techniques minimize the risk of complications and shorten recovery time. It’s important to remember that the success of a tonsillectomy depends not only on the surgeon’s expertise but also on adherence to postoperative recommendations. For safe and effective treatment, it is advisable to consult an ENT Specialist West Yorkshire, who can provide expert evaluation, recommend the most appropriate surgical approach, and guide you through a smooth recovery process.