Tonsillectomy

What are tonsils?

Tonsils are small glands within the throat, one on each side. They are a part of the lymphoid system and help us fight germs when you are young. Your body can fight the germs even without them. They need to be removed only if they are doing more harm than good.

Why take them out?

Tonsils need to be removed only if you are getting lots of sore throats, making you loose time from work or school. The sore throats for children are treated with antibiotics but frequent use of antibiotics can be harmful. . Antibiotics are not helpful and only produce temporary relief. They have side effects and may promote ‘super-bugs’ that are resistant to antibiotics.

Sometimes in both in children and adults, the tonsils are so big that they may block their breathing in the night time. Some people even stop breathing for a few seconds while they are asleep. This may reduce the oxygen supply into their bodies and thus is detrimental to health. This may make long term heart and lung problems for them. In such people tonsils may be removed to improve their breathing at night.

Alternative treatments available:

Children may sometimes grow out of all these problems. You may just want to wait and see if your tonsil problem gets better by itself. Only you can decide if your sore throats are so much of a problem that you want surgery.

Low dose of antibiotics can be given over a month or longer can be tried to see if it helps reducing the number of attacks of tonsillitis. This alternative is useful to tide over times like examinations or important meeting times for office goers till they can get time to get their tonsils out.

Before the operation:

It is advisable to take a weeks off from work or school for post-op recovery. If you have a cold, flu or fever a few days before the operation please inform your doctor about the same.

How is the operation done?

You will be put to sleep under an anaesthetic. We will remove the tonsils out through your mouth. We use a special instrument called “COBLATION” or “Starion” for removing the tonsils. This device uses plasma energy and it operates only at 40-50 degree Centigrade so it is gentler to the tissues and creates fewer side effects after surgery including pain and bleeding. Thus there are no cuts or sutures on the neck. The operation takes about 20 minutes or so. But you may be in the recovery room for another half an hour or so.

After the operation?

Your throat will be very sore initially and you can ask for pain killers when required. It is very important that you start swallowing movements as soon as possible as this will prevent your throat muscles from going into spasm. You should start eating and drinking as soon as allowed.

Usually if you are feeling well enough and you are eating and drinking we will let you go home the morning after the operation. We could also consider you going home the same day if you are well enough and eating and drinking properly.

Sore throat and ears?

Your throat will get better day by day. Take painkillers as advised. You may have sore ears. This is because your ears and throat have the same nerves. It does not necessarily mean you have an ear infection.

Eat normal food.

Eating food will help your throat to heal. Prepare normal food for them. It is better to give them cold and soft food for one week after the surgery. Chewing and swallowing will help reduce the pain. Always have a drink with your meal. Chewing gum will also help with the pain.

If you do not eat properly after the operation there is more pain in the throat because of spasm of the muscles, this will prevent you from eating further and it becomes a vicious cycle. Also if you do not eat properly after surgery secretions tend to collect in your throat and this will attract infection which can be a cause of your bleeding.

Please avoid eating spicy and very hot food atleast in the first week after the operation.

Drink lots of fluid. Avoid aspirin or aspirin like medications.

Your throat will look white? This is normal while your throat is healing.

Stay off work or school for 7 days. Rest at home away from crowds and smoky places. Stay away from people with coughs and colds. Ask your nurse if you need a sick note. You may also feel tired for the first few days. Avoid strenuous activity like vigorous exercises.

Possible Complications:

Although tonsil operation is very safe but every procedure is associated with its own risks.

Many patients may have low-grade fever up to 101.50F (380C). Give paracetamol and plenty of fluids. Higher fever should be reported to the doctor.

Bleeding from the throat is the most serious problem. Worldwide about 2 in 100 children could suffer with some form of bleeding after this operation. This risk has been seen to be a little higher for adults and 5% of adult patients have been reported to have bleeding after tonsillectomy. This bleeding can range anything from only a few drops of blood that you see may be once to more serious bleeding. If you have bleeding from the throat it is best you come back to the hospital emergency and the doctor will examine you and advise as required at the time.

Only 1 in 100 will require a second operation to control this bleeding from the throat.

Most commonly this bleeding from the throat is due to infection of the operated area and comes under control with antibiotics and gargles.

Some people may feel sick after the operation and we will give them medicines as required.

Sometimes your teeth may be chipped or broken with the instruments that we use in the surgery especially if your teeth are loose. Please let the doctors know of any such teeth prior to the operation.