Tonsillectomy - Tonsil Removal Surgery

Tonsil Removal Surgery is one of the most common procedures in otorhinolaryngology.

Tonsillectomy is an otorhinolaryngological operation in which the tonsils (tonsils, mandibles) are surgically removed. Tonsils are round, spherical organs, or collections of lymphatic tissue, and we have one tonsil on each side of the throat. In addition to the tonsils, which we can see ourselves when we look at our mouth in the mirror, there is also adenoid tissue (the so-called third tonsil) which is located at the back of the nose and can only be examined with a fiberoptic examination. The operation that removes the third tonsil is called adenoidectomy.

What are tonsils and what is their role?

Tonsils are organs that serve as the immune system's first line of defense against swallowed or inhaled foreign particles, and as such, with their good blood supply, they help the immune response to respond to common illnesses such as the common cold. Fortunately, they are not the body's only defense against infection, because sometimes the tonsils can become more harmful than helpful. Due to the tonsils being exposed to numerous pathogens, they often become enlarged, tonsillitis or inflammation of the tonsils develops, or difficulty breathing, snoring, and feeding problems occur. The problems are predominantly expressed in childhood, although adults are not spared from these problems either. In addition to obvious and easily visible problems with the tonsils, such as inflammation or snoring, infected tonsils can also lead to damage to other organ systems, such as the joints, kidneys, and heart

Indications for tonsillectomy

Given the long history of the operation and numerous studies on tonsillectomy, the indications for surgery are clearly defined:

• frequent bacterial sore throats (tonsillitis, purulent tonsillitis) - inflammation accompanied by purulent plugs on the tonsils and high fever, which ultimately require antibiotic treatment
• complications of tonsillitis - peritonsillar abscess, sepsis
• respiratory obstruction
• apnea (snoring, interruption of breathing during sleep)
• chronic throat inflammations (persistent sore throat accompanied by bad breath)
• suspected tumor

In addition to these indications, one should also consider removing the third tonsil in children who have difficulty breathing through the nose due to enlarged adenoids, children who snore, have frequent ear infections or chronic serous ear infections that lead to hearing loss.

What does tonsillectomy look like?

Tonsil removal surgery is performed under general anesthesia and takes about 30 minutes. It is recommended to stay in the hospital overnight to better control postoperative pain. It is possible to have both tonsillectomy and third tonsil surgery in the same operation. The operation to remove both tonsils and third tonsil is called a tonsilloadenoidectomy. Unlike most other surgical procedures in which the wound is sutured, that allows for so-called primary wound healing, with tonsillectomy this is not possible, but the wound is allowed to heal on its own. For this reason, the pain after tonsillectomy is quite pronounced, especially in adults, and there is a greater possibility of postoperative bleeding, which can occur at any time during the two-week period after surgery. Bleeding after tonsillectomy is an emergency that requires prompt care. Therefore, it is extremely important to follow the instructions on postoperative care, nutrition, painkillers and to be well hydrated (drink plenty of fluids), as this significantly reduces the possibility of complications.