Tonsillectomy

The tonsils are 2 pads of lymphoid tissue one on each side of the back of the throat.

Tonsillectomy is surgical procedure that completely removes the tonsil, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. 

Does tonsillectomy affect immunity? 

With recurrent tonsillitis, the controlled immunological process in the tonsils gets affected and the tonsils are no longer able to function adequately in local protection, nor can it appropriately reinforce the secretory immune system of the upper respiratory tract. There would therefore appear to be a therapeutic advantage to removing recurrently diseased tonsils. There are no studies to date that demonstrate a significant clinical impact of tonsillectomy on the immune system. 

When would a tonsillectomy be performed: 

• Recurrent tonsillitis: at least seven episodes in the past year, at least 5 episodes per year for 2 years, or at least 3 episodes per year for 3 years. 
• Obstructive sleep apnea. 

Preparing for tonsillectomy 

• Laboratory testing (blood tests) and possible medical assessment to be done before surgery. 
• You/ the child need to be assessed by anesthesiologist.
• You may need to adjust your/his current medications if you are taking any. (like blood thinners…)
• Avoid taking aspirin, anti-inflammatory drugs and some herbal supplements as they can increase the possibility of bleeding.
• Arrange for care for your child as tonsillectomy is day care procedure and don’t plan anything for 2 weeks after the surgery. 
• Prepare soft foods which are preferred by the child to promote eating after the surgery. 

Tonsillectomy usually a day care procedure but if the child is less than three years or has obstructive sleep apnea then the child will be kept for 24 hours for observation. 

Surgical steps: 

• The surgery will be done under general anesthesia.
• Tonsillectomy can be done using 2 methods either cold dissection (using sharp dissection using scalable without cautery); or using hot dissection using bipolar/ coblation. 
• In both ways the tonsil will be removed with its capsule from the adjacent muscular wall.
• In both way hemostasis will be done ensuring no bleeding using mainly cautery. 
  

Recovery:

• Pain is common and may get worse 5-7 days after the surgery. This pain is worse in the morning due to dryness so proper hydration should be insured and may last up to 2 weeks. Pain killers will be provided and should be taken regularly as planned by the surgeon. 
• There may be discoloration (white colored slough) where the tonsils were removed. When the area is healed completely the discoloration will disappear.
• You should plan on resting at home for at least a week after the tonsillectomy, and limit activity for 2 weeks.
• Make sure to drink/ give the child enough fluids. Soft and/or cool foods often are easiest for about one week, but you may feel free to add things to your diet as long as you can tolerate the foods.
• Avoid hard and spicy foods.
• Come back/ bring your child back to the hospital in case of bleeding, dehydration and uncontrolled fever. 

Complications: 

• Bleeding. 
• Injury to the lips, tongue, teeth or jaws.
• All these complications and other less frequent complications will be mentioned and explained thoroughly in the pre surgical consent by the surgeon. 
  
  

For detailed videos and images of this procedure, click here