Tonsillectomy has long been one of the most common surgical operations performed around the world, particularly among children, and is usually recommended for severe or recurrent tonsillitis. (1)

If you're considering a tonsillectomy -either you or your child- this guide can help you better understand the procedure and make an informed decision in consultation with your doctor.

What are Tonsils? Are They Important?

Tonsils are two small masses located at the back of the throat on each side. They are part of the immune system, helping in fighting bacteria and germs. (2)

By the age of three, tonsils become less important in combating disease, and the body can fight infection without them. Tonsils typically shrink in size as children grow older, but in some cases, they remain enlarged or cause health problems that may require removal. (2)

When is a Tonsillectomy Recommended?

Indications for tonsillectomy are limited to the following: (3)

• Chronic/Recurrent Tonsillitis:some text
  • At least 7 episodes in the past year.
  • At least 5 episodes in a year in the last two years.
  • At least 3 episodes in a year in the last three years.

• Severe bacterial tonsillitis resistant to antibiotics and does not respond to treatment.
• Severe respiratory problems that affect sleep, including snoring or sleep apnea.
• Tonsillar abscess that doesn't improve with drugs or can't be drained.
• Other conditions include bleeding tonsils, severe tonsil stones, or tonsillar cancer.

The decision to undergo a tonsillectomy is often difficult when there are no severe/chronic infections or sleep disturbances. However, frequent tonsillitis or other tonsil-related issues may still warrant the procedure. In such cases, a thorough consultation with a physician is essential to determine the most appropriate treatment option.

Our ENT specialists at Dr. Soliman Fakeeh Hospital provide expert consultations, evaluations, and treatment recommendations for different tonsil conditions.

What Are the Benefits of a Tonsillectomy?

The procedure can help: (1)

• Improve sleep.
• Avoid the recurrence of tonsillitis.
• Improve the quality of life.

Remember, children can still have colds and sore throats after surgery, but without the complications caused by enlarged tonsils.

What Are the Risks of a Tonsillectomy?

Tonsillectomy is generally safe, but like any surgery, it comes with potential risks, including bleeding, infection, or a severe reaction to anesthesia. (3)

The most common post-tonsillectomy side effects are mild and improve gradually in just a few days, including the following: (3)

• Fever up to 38°C for 1-2 days.
• Mild to severe throat pain, which can persist for 1-2 days; may radiate pain in the ears, neck, or jaw.
• Nausea and vomiting.
• Swelling of the uvula (feeling something is stuck in the throat).
• Bad breath for up to 2 weeks.

What to Expect: Before, During and After a Tonsillectomy

• Pre-Surgery: Patients must fast the night before surgery (even water). The physician may also recommend that the patient stop certain medications for a short time before the surgery, especially blood thinners.
• During Surgery: The operation is performed under general anesthesia, with tonsils removed through the mouth using surgical instruments, heat, or other methods. No external incisions are made. It takes approximately half an hour.
• After Surgery: Patients can usually return home the same day. You may experience nausea and dizziness for a few hours afterward, but typically subside quickly.
• Recovery Time: Mild discomfort may persist for a few days, with full recovery in 1-2 weeks. (4)

 Are There Alternatives to Tonsillectomy?

A tonsillectomy may not always be necessary. In many cases, the issue may resolve on its own as children grow out of recurrent tonsillitis. A "wait-and-see" approach may be suitable, while medications and home remedies can temporarily alleviate symptoms. (2)

For persistent infections, doctors might prescribe low-dose antibiotics for several months, though long-term use should be carefully monitored due to potential side effects. (2)

Conclusion

The decision to proceed with a tonsillectomy should be guided by the severity of the symptoms and the specific condition of the tonsils. Only a doctor can determine whether surgery is the best option or if it would be better to wait for the symptoms to improve on their own over time.

References

1. Cleveland Clinic - Tonsillectomy
2. CUH - Tonsillectomy
3. Mayo Clinic - Tonsillectomy
4. Healthdirect australia - Tonsillectomy

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