Tonsil removal (tonsillectomy)

What is a tonsillectomy?

A tonsillectomy is an operation to remove the tonsils. Tonsils are lymphoid tissues (like the glands in your neck) that fight infections from germs inhaled or swallowed. Tonsils become less important in fighting infection as you age. If your surgeon has recommended a tonsillectomy the decision to proceed with the surgery is ultimately yours.

What are the benefits of surgery?

Tonsillitis happens if the tonsils become infected. This causes pain, fever and difficulty swallowing and can make you feel unwell. Tonsillitis usually gets better within 7 to 10 days.

When tonsillitis is caused by a virus, antibiotics do not help, but if it's caused by bacteria, antibiotics may help.

You can still get sore throats after a tonsillectomy, such as those caused by a common cold. Tonsillitis can be prevented by the operation, but it won't prevent all sore throats.

Are there alternatives to surgery?

Only surgery can stop tonsillitis from returning, which is the only dependable method.

Children may stop experiencing frequent infections after a long course of antibiotics, or tonsillitis may simply stop after a few years. Adults are less likely to benefit from this treatment, especially after glandular fever.

What will happen if I decide not to have the operation?

It is likely that you will continue to get tonsillitis. An abscess can sometimes form behind the tonsils - this is known as a 'quinsy'. The pus will need to be removed from the abscess through a needle, and you will need antibiotics. Rarely, the infection may spread further into the tissues of your neck, causing a 'parapharyngeal' or 'retropharyngeal' abscess. This is a serious complication and needs an operation to drain away the pus for a full recovery.

What does surgery involve?

The nursing team will carry out a number of checks before your operation. The operation is performed under a general anaesthetic and usually takes about 30 minutes. You may also have injections of local anaesthetic to help with the pain after the operation.

Your surgeon will perform the tonsillectomy through your mouth using one of the following techniques.

Cold dissection technique - Your surgeon will use a steel instrument to peel or cut the tonsil away from the layer of muscle underneath it.

Diathermy technique - Your surgeon will use a diathermy instrument that uses heat to remove the tonsil and cauterise the area.

Coblation technique - Your surgeon will use an instrument that uses radio-frequency energy to dissolve the tonsil. Your surgeon will stop any extra bleeding

After your tonsillectomy

You should be able to go home the day of your surgery as tonsillectomy is performed as a day case. The pain may last for up to two weeks. It will tend to be worse first thing in the morning. Over-the-counter painkillers should help.

You will need to stay off work or school and away from groups of people for two weeks after the operation. This is to help prevent throat infections while your throat is still healing.

The majority of people make a good recovery and return to normal activities following a tonsillectomy. As with any surgery, there can be complications:

• Bleeding
• Some pain
• Infection in the surgical wounds