What are tonsils?

Tonsils are a mass of lymphatic tissues inside the mouth at the back of the throat. The tonsils are parts of a lymphatic tissue ring which can easily be found in the oral cavity and the pharynx.

As being part of the immune system, this ring is the first immunological filtering station in providing protection against infections.

When does the patient need surgical removal of the tonsils?

Acute tonsillitis is an infection of the tonsils that can make one’s tonsils swell and cause a sore throat, fever, troubles with swallowing, and also enlarge the glands around the neck. It is often caused by bacteria (streptococcus species). Frequent episodes of tonsillitis (recurrent tonsillitis) might be a good reason for one to have a tonsillectomy.

Chronic tonsillitis may lead to a permanent sore throat, bad breath, and constantly enlarged lymph nodes on the neck. It can be the reason for patchy hair loss, joint complaints, and skin rashes of uncertain origin, fatigability, a permanent rise in body temperature or fever and chronic urogenital inflammations. In these cases, surgery is necessary.

The operation is also indicated in case of enlarged tonsils. Enlarged palatine tonsils may significantly narrow the throat, which may cause swallowing - or respiratory difficulties, and may contribute to snoring and obstructive sleep apnea syndrome (OSAS).

After this surgery, the body will still be able to fight infections because sufficient amounts of lymphatic tissue can be found in the oral cavity and the pharynx (adenoid, lingual tonsils, etc.).

How does Removal of Tonsils work?

Tonsillectomy is the surgical removal of the tonsils, and it is often performed parallel to adenoidectomy. The surgical procedure lasts about 40 minutes and is performed under general anesthesia and usually in antibiotic prophylaxis.

There are many kinds of ways to remove the tonsils the most common method is called “dissection and snare method.” In this case, the tonsil is dissected along with its capsule and lifted out of its bed and is ultimately removed using a tonsillar snare.

In the meantime, bleeding tissues are cauterized. Other methods are also used in the hospital to perform a tonsillectomy, like laser and coblation tonsillectomy. The major advantage of the coblation procedure is reduced bleeding and milder postoperative pain.

What are the risks and benefits of Removal of Tonsils?

Risks associated with Removal of Tonsils:

As with any surgery, there are certain risks associated with tonsillectomy, including various infections and bleeding. The risk of bleeding is higher after some days of surgery when scabs fall off in small pieces from the tonsillar bed.

One will get a patient information sheet and informed consent form for detailed information about tonsillectomy, risks of the operation, and perioperative tasks. By all means, the patient will discuss with his doctor the possible risks of surgery before he makes a treatment decision.

There are certain risks associated with general anesthesia, for which the hospital will provide a separate information sheet and informed consent form. The tests that the patient will undergo before his surgery will ensure that these risks are reduced to the minimum.

It is important to call the surgeon immediately in case of blood spitting or vomiting, permanent nasal bleeding, fever or a serious headache.

Benefits of Removal of Tonsils:

Removal of the tonsils may reduce the frequency and severity of throat infections. It may also prevent the development of potentially serious kidney-, heart-, joint or brain conditions following streptococcal pharyngitis or tonsillitis (rheumatic fever). In case of enlarged palatine tonsils, tonsillectomy will improve swallowing- and respiratory difficulties.

In addition, the patient may reduce antibiotic intake related to infections due to recurrent tonsillitis.

How should the patient prepare for Removal of Tonsils?

• Prepare a list of all of the symptoms and other medical conditions, past illnesses and allergies, even if they seem unrelated to the patient’s nose or sinuses. For this reason, the patient will receive a detailed questionnaire to complete, followed by a physical examination.
• Be aware of any pre-appointment restrictions. The ENT surgeon will provide the patient with all the necessary information so that he can prepare himself for the diagnostic tests.
• List all the patient’s medications and drugs, including vitamins and supplements
• Ask a family member or friend to accompany the patient, someone who can help him recall all the information to be provided during his consultation.
• Before the surgery one will get a patient information sheet and an informed consent form with the necessary pre and postoperative information to read and sign.