Tonsillectomy

Tonsillectomy (tahn-suh-LEK-tuh-me) is surgery to remove your tonsils. Tonsils are round, fleshy masses in the back of your throat. Unless you’ve had them removed, you have two — one on each side. They’re a part of your immune system.

Sometimes, they can become inflamed and cause painful sore throats. They can swell and block part of your airway. This may make it harder to breathe during sleep.

While adults sometimes need tonsillectomies, it’s more common in children. Your tonsils get bigger during childhood and can shrink as you get older. That’s why children are more likely to need a tonsillectomy.

How do you know if you need a tonsillectomy?

Healthcare providers recommend this surgery for two main reasons:

• To treat breathing-related sleep disorders, like sleep apnea
• To reduce the risk of infection in people with frequent or chronic tonsillitis

Up until the 1980s, providers frequently performed tonsillectomies for tonsillitis. Nowadays, providers do them more often to treat sleep apnea.

How should I prepare for this procedure?

Before surgery, your healthcare provider will check to make sure you’re healthy enough for surgery. This may involve getting blood tests.

Your provider will give you instructions to help you prepare. For example, you may need to stop taking certain medicines several days before surgery. You may need to fast the night before.

Follow these guidelines closely.

What happens during this procedure?

Your healthcare provider will give you general anesthesia to keep you asleep and comfortable during your procedure. Next, they’ll remove your tonsils. Since you’re asleep, you won’t feel pain. Surgeons use many methods to perform tonsillectomies, including:

• Electrocautery: This method uses heat to remove your tonsils and stop any bleeding.
• Microdebrider: This treatment uses a powered rotating shaver to remove part of your tonsils.
• Coblation tonsil: A provider can remove either all of part of your tonsils using radiofrequency and a plasma ion field.

How long does this procedure take?

A tonsillectomy usually takes about 20 to 30 minutes to complete. It could take longer in some instances.

For example, some children need surgery to remove their adenoids and tonsils. Like tonsils, your adenoids can become swollen. Instead of performing the procedures separately, providers often perform them together. This may add to the total surgery time.

What are the advantages?

Having a tonsillectomy can offer many benefits, including:

• Better sleep quality
• Fewer infections
• Improved quality of life

What are the risks of having this procedure?

While complications are rare, they can happen. Possible risks include:

• Excessive bleeding (either during surgery or after)
• Swelling of your tongue or the roof of your mouth
• Surgical wound infection
• Reaction to anesthesia
• Changes to your sense of taste
• Dehydration
• Needing additional procedures
• Injury to your lip, tongue and teeth

What happens after a tonsillectomy?

After your surgery, your medical team will move you to a recovery area. There, your healthcare provider will check your vital signs and make sure there are no complications.

Tonsillectomy is usually an outpatient procedure. This means you can go home on the same day. Complications are rare. But if they arise, your provider might keep you in the hospital overnight to monitor your progress.

What’s the recovery time?

On average, most people reach full recovery in about two weeks. Recovery time depends on things like the type of tonsillectomy you had, how quickly your body typically heals and whether you experienced any complications.

Recovery stages

While healing looks a little different for everyone, here’s a general timeline of what to expect during recovery:

One to two days after

• Throat pain
• Low-grade fever
• Fatigue
• Bad breath
• Difficulty speaking/hoarseness
• Feeling of fullness in your throat (due to swelling)

Three to five days after

• Continued sore throat, which may worsen around day three or four
• Fatigue

Five to 10 days after

• Scabbing

What can I eat after a tonsillectomy?

Drinking lots of fluids is key to a successful recovery. You’ll want to eat soft, cool foods for the first week. You can try solid foods once your comfort level allows. But you should avoid crunchy and spicy foods, as they can irritate the surgical area.

Food and drink recommendations during recovery include:

• Water, tea and juice
• Ice cream
• Smoothies
• Yogurt
• Pudding
• Applesauce
• Broth
• Mashed potatoes
• Scrambled eggs

When can I go back to work or school?

It’s best to take at least 10 days off work or school following a tonsillectomy. Staying at home helps reduce your risk of colds or other infections after surgery.

When should I see my healthcare provider?

After a tonsillectomy, you should call your healthcare provider if you develop:

• Bleeding
• Difficulty breathing
• Pain that gets worse after five days or doesn’t improve with pain medication
• Nausea and vomiting
• Signs of dehydration
• A fever higher than 101 degrees Fahrenheit (38.3 degrees Celsius) that doesn’t improve with medication

What is the 7 5 3 rule for tonsillectomy?

The 7 5 3 rule helps healthcare providers decide whether a child needs surgery for tonsillitis. It’s also called the Paradise criteria. It’s named after Dr. Paradise, the pediatrician who developed it.

Your child may be a good candidate for this procedure if any of the following applies:

• Your child has had tonsillitis at least 7 times in the past year.
• Your child has had tonsillitis at least 5 times within each of the past two years.
• Your child has had tonsillitis at least 3 times within each of the past three years.

How painful is tonsillectomy?

You can expect to feel some pain and discomfort following a tonsillectomy. This is normal and usually improves in a week or two. In general, recovery is more difficult for adults than for children. Your healthcare provider will give you medications and instructions to help ease any pain.

Does having no tonsils affect your immune system?

Many people worry that removing their tonsils will have a negative impact on their immune systems. But having a tonsillectomy doesn’t weaken your immune system. Your body can still fight off germs.

Keep in mind, though — even if you have your tonsils removed, the tissues in your throat can still become infected and sore.