Tonsillectomy (Adult)

What is a tonsillectomy?

A tonsillectomy is a surgical procedure to remove the tonsils, two small glands located at the back of your throat. While this procedure is more commonly performed in children, adults may need a tonsillectomy to treat recurring or severe throat problems.

Why might you need a tonsillectomy?

Your tonsils are part of your immune system and help fight infections, particularly in childhood. However, they can sometimes cause problems, especially if they become repeatedly infected or enlarged. Reasons you may need a tonsillectomy include:

• Recurrent tonsillitis: Frequent or severe infections of the tonsils that disrupt your daily life.
• Tonsilloliths (tonsil stones): Persistent, hard stones in your tonsils causing discomfort or bad breath.
• Sleep problems: Enlarged tonsils can lead to obstructive sleep apnoea or disrupted sleep.
• Quinsy: An abscess near the tonsils that doesn’t respond well to other treatments.
• Suspected cancer: If there is concern about abnormal growths or changes in the tonsils.

What preparation is required?

Before a tonsillectomy, you will need to prepare to ensure a smooth procedure and recovery:

• Medical review:
  Your doctor will review your medical history and may conduct blood tests to ensure you’re fit for surgery. Inform them of any medications or allergies.
• Adjust medications:
  If you take blood-thinning medications (e.g., aspirin or warfarin), you may need to stop them temporarily. Follow your doctor’s guidance.
• Fasting:
  You’ll need to stop eating and drinking for at least 6–8 hours before the procedure, as it’s performed under general anaesthetic.
• Plan for recovery:
  Arrange for someone to accompany you home and assist you after surgery, as you won’t be able to drive or manage tasks immediately after.

What does the procedure involve?

A tonsillectomy is performed under general anaesthetic, meaning you’ll be asleep throughout the surgery. The procedure typically takes 30–60 minutes and involves:

• Accessing the tonsils:
  The surgeon will access your tonsils through your mouth, so there are no external cuts or scars.
• Tonsil removal:
• • Cold steel surgery: Traditional instruments are used to remove the tonsils.
  • Diathermy or cautery: Heat is applied to remove the tonsils and seal the area to reduce bleeding.

1. • Coblation: A method using radiofrequency energy and saline to dissolve the tonsil tissue.

• Completing the procedure:
  Once the tonsils are removed, the area is checked for bleeding before you are taken to recovery.

Your surgeon will discuss the best approach for your specific needs

What are the benefits?

Tonsillectomy can provide significant relief from throat-related issues. Benefits include:

• Fewer infections: Reducing the frequency and severity of tonsillitis.
• Improved sleep: Alleviating sleep apnoea or snoring caused by enlarged tonsils.
• Relief from symptoms: Improvements in sore throat, difficulty swallowing, and bad breath caused by tonsil stones.
• Enhanced quality of life: Fewer illness-related disruptions to work or daily activities.

What are the potential risks and complications?

Tonsillectomy is generally safe, but as with any surgery, there are risks to be aware of:

• Bleeding: This can occur during or after surgery. Seek immediate medical attention if bleeding is significant.
• Infection: Signs include fever, worsening throat pain, or a foul smell from the throat.
• Pain: A sore throat is expected and may extend to the ears, neck, or jaw but usually subsides within two weeks.
• Changes in voice: Rarely, removing the tonsils can cause subtle and temporary changes in your voice.
• Dehydration: Pain or discomfort when swallowing may reduce fluid intake, increasing the risk of dehydration.

Your surgeon will explain these risks and answer any questions before the procedure

Recovery after the procedure

Hospital stay:
Most adults can go home the same day, although some may need to stay overnight, especially if you experience any complications or have other health conditions.

Pain and discomfort:
You’ll experience a sore throat for up to two weeks. Pain relief medication will be provided to help manage discomfort, which may also affect your ears or neck.

Diet:
You’ll be encouraged to eat and drink normally, even if it feels uncomfortable, as this helps keep the area clean and reduces the risk of infection.

Activity restrictions:
Take at least two weeks off work or strenuous activities. Avoid heavy lifting and follow your surgeon’s advice about when to resume normal activities.

Healing time:
Recovery from a tonsillectomy takes time, but with the right care, you’ll soon start to feel the benefits. Most people need about two weeks to recover fully, with the first few days being the most uncomfortable. During this time, it’s important to rest, stay hydrated, and eat a balanced diet to support healing. Follow your doctor’s advice regarding pain relief and activity restrictions and be patient with your body as it heals. Once recovery is complete, you can look forward to fewer throat infections, better sleep, and improved overall wellbeing.