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Should You Have Your Tonsils Removed?

Dr. Noor A. Sheikh

3 min read

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Frequent in children and rare in adults, tonsil infections are often no more than a bad case of sore throat, sometimes requiring antibiotic treatment in case of a bacterial infection. Therefore, surgical removal of tonsils is reserved mostly for children with recurrent or chronic tonsillitis and allergies to antibiotics. Because the occurrence of a sore throat is fairly common, it may be difficult to determine when to visit a doctor.

If you are suffering from consistent high fever, a hoarse voice, enlarged or swollen lymph-nodes or glands in the neck, pain and discomfort swallowing and breathing, pain on one side of the throat or a white or yellow coating on your tonsils, it is advisable to pay your doctor a visit. 

According to the doctors, other reasons that might require a tonsil surgery include:

Airway Obstruction

Infection or allergy induced abnormal tonsil enlargement might block the nasal passages. This causes forced mouth-breathing, a dry mouth and adverse facial structure changes. It may also lead to Obstructive Sleep Apnea, a serious medical condition which causes severe breathing issues, whereby you stop breathing many times over the course of the night and your sleep patterns are disrupted.

Recurrent Chronic Infections

Regular, severe episodes of tonsil infection in a year, 10 infections in 2 years or 9 infections in 3 years may warrant removal. Tonsils infections are considered severe if there is:

  • A bacterial infection
  • A fever higher than 38 C
  • Tender lymph nodes in the neck
  • A pus-like coating on or around the tonsils

Halitosis

In addition to constant bad breath, halitosis also causes the formation of terrible-tasting tonsiliths (white tonsil stones) due to excessive inflammation of the tonsils. If traditional treatment fails, this condition might call for the surgical removal of the affected tonsils.

Tonsil Cancer

Although rare, children with Lymphoma (cancer of the lymph nodes) or adults suffering from Squamous Cell Carcinoma (cancer in the epidermis, or outermost layer of the skin) might need to have their tonsils removed.

Peritonsillar Abscess

Common in teenagers and young adults, abscesses are a painful collection of pus behind the tonsils, which may also spread to the neck, culminating in blocked airways and breathing difficulties. In this case, the tonsils may have to be removed is surgically draining them is not effective.

Otitis Media (Glue Ear)

In this condition, swollen adenoids block the Eustachian tube connecting the pharynx and the middle ear. This results in the formation of sticky fluid in the middle ear over time, which causes hearing difficulty and even hearing loss. Other recurring ear infections might also lead to tonsil removal.

Quinsy

Sometimes, throat infections can spread into the tissues surrounding the tonsils, resulting in the formation of a painful abscess known as a ‘per-tonsillar abscess’, which then causes interference in breathing and swallowing. Antibiotics or surgical drainage of the tonsils are usually applied for mild or extreme cases, respectively.

Procedures For Tonsil Removal

Tonsillectomy

Surgical removal of the commonly infected palatine tonsils lasts between 30-45 minutes minus anaesthesia. Tonsillectomy is a relatively simple outpatient (not requiring a hospital stay) procedure, commonly reserved for children.

Tonsils can either be Completely Removed or Partially Removed (Intracapsular Tonsillectomy)-which is only performed in children under 3 years in order to reduce recovery pain. However, the tonsils can grow back and cause possible reinfection.

Adenoidectomy

Adenoidectomy is performed in children below age 4 and involves the removal of infected adenoids via Curette scraping, Electrocautery Ablation using electric current or Coblation, in certain cases. Regardless of the procedure, 5-10% adenoids grow back later in life.

Coblation

Tonsils may also be removed via a plasma field, which cleanly cuts the infected tonsil by dissolving the soft tissue that connects it to the neck. This results in little to no throat bleeding-a common problem in traditional tonsil-removal procedures. The procedure in total takes 30-45 minutes including anesthesia.

T&A (Tonsillectomy and Adenoidectomy)

Commonly employed for children, T&A is the simultaneous removal of the palatine tonsils and adenoids, usually due to an infection in both tonsil types, or if the palatines are infected and adenoids are unusually enlarged and cause breathing problems. In adults, it is used as a treatment of sleep apnea. The procedure is comparatively less painful for children than adolescents and requires a 10-day recovery period.

Post-Surgery

Patients might experience the following symptoms:

  • Mild to severe ear, jaw and neck pain
  • Light bleeding
  • Fever
  • Inflammation

Postoperative care includes drinking a lot of fluids, including water, apple juice, grape juice and fluids rich in electrolytes, such as Gatorade. Soft foods such as yoghurt, puddings, apple sauce, jellos are encouraged, while hot and spicy, as well are crunchy and hard foods should be avoided for a while.

Strenuous physical activity is discouraged for at least seven to ten days. It is advised to avoid, at least for two weeks, medication that contains aspirin, ibuprofen, or other anti-inflammatory medication.

The pain is usually worse at night and can prompt the requirement of additional pain medication. Another common occurrence is ear pain while swallowing, and this is not to be taken as an ear infection- it is referred pain from the surgery. Tylenol or Tylenol with Codeine may prove an effective remedy.

A stiff neck may occur as well. Icing the areas that cause pain with an ice-pack or ice cubes in a towel may assist in relieving some pain.

Contact a doctor immediately in case of excessive bleeding within or after 10 days following surgery.

If your child is experiencing any of the above issues related to tonsils, consult with an ENT specialist as soon as possible. You can book an appointment with a top ENT Specialist in Karachi, Multan and Islamabad through oladoc.com. Or call our helpline at 042 3890 0939 for assistance to find the RIGHT Doctor for your tonsil troubles.

Disclaimer: The contents of this article are intended to raise awareness about common health issues and should not be viewed as sound medical advice for your specific condition. You should always consult with a licensed medical practitioner prior to following any suggestions outlined in this article or adopting any treatment protocol based on the contents of this article.

Dr. Noor A. Sheikh - Author Dr. Noor A. Shaikh is a leading ENT specialist and surgeon based in Karachi. He has deep expertise in the treatment of conditions like headaches, head & neck surgeries, thyroid problems, and ear cleaning. You can seek appointment with him through oladoc.
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