Are you frequently battling tonsillitis? If you are, you might consider having your tonsils removed. We discuss the main symptoms of tonsillitis and the key benefits of a tonsillectomy.
Tonsillitis may be a common frustration, but that doesn't mean you have to live with recurring episodes. A tonsillectomy is a surgical procedure that involves removing the tonsils which can significantly reduce your chances of suffering with the condition.
What are tonsils?
The tonsils are small glands either side of the throat that help to stop infection from spreading. As soon as the tonsils become infected, the virus or bacteria stays in the glands rather than spreading to other parts of the body. As we get older, the immune system strengthens and the tonsils are usually no longer used to fight infection.
What is tonsillitis?
Tonsillitis occurs when the tonsils become inflamed as a result of a viral or bacterial infection. They usually swell and feel sore, making it uncomfortable to swallow. Other symptoms include a headache, high temperature (fever), earache and coughing. Tonsillitis normally refers to the palatine tonsils rather than the lingual tonsils, which sit on the back of the tongue.
As tonsillitis is often caused by a viral infection, medication has a limited effect. You’ll usually be advised to take painkillers to manage the uncomfortable symptoms. In more severe cases, pus-filled spots can appear on the tonsils and they become so swollen that it is difficult to eat, drink or breathe. In this instance, your doctor may take a throat swab. If the test shows that the tonsillitis is caused by a bacterial infection, then you may be prescribed antibiotics.
When adults or children frequently suffer from tonsillitis, it might be advised that the tonsils are removed. Children who have at least four episodes of tonsillitis a year for two consecutive years are typically recommended to have their tonsils removed. Adults are recommended to have a tonsillectomy after fewer attacks. This is because these attacks tend to be more severe and adults are less likely to be able to fight off the infection without treatment.
A tonsillectomy is also recommended if quinsy is present. This is a rare complication when an abscess grows on the wall of your throat as a result of tonsillitis.
What to expect from surgery
A tonsillectomy is performed under general anaesthetic and most patients are able to go home the following day. It’s typically a short operation, taking around one hour. The tonsils are either cut from the muscle underneath or the area is cauterised using heat.
Most patients can return home the day after their operation, but it can take up to two weeks for the pain to diminish completely. During this period, it’s recommended that you remain off work or away from school to help prevent you from catching an infection while your throat is healing.
The main benefits of surgery
Once the tonsils have been removed, recurring bouts of tonsillitis will usually stop. Those who often have tonsillitis caused by bacterial infections will experience fewer infections and reduced prescriptions of antibiotics. This also helps to reduce bacterial resistance to infection-fighting drugs.
One study showed that adults who suffer from a recurring sore throat as a form of tonsillitis experience a significant improvement in quality of life after tonsillectomy. They also take less medication, have fewer days off work and experience a reduction in visits to the doctor1.
Having tonsils removed helps to prevent further complications as a result of reoccurring infections. These complications include more severe illnesses such as middle ear infections, scarlet fever, rheumatic fever and glomerulonephritis. Sleep apnoea is another known complication of tonsillitis where the walls of the throat relax, which makes it difficult to breathe while sleeping.
Every patient is different and most people don’t suffer complications. However, as with any operation there is the risk of bleeding and infection to the wound while it heals.
Some patients experience specific complications after their surgery. Lingual tonsillitis can occur. This is an infection that attacks the lymphatic tissue located on the back of the tongue. However, this is uncommon. If you decide to have surgery, your consultant will discuss potential complications with you before surgery.
Your questions answered
Consultant ENT surgeon, Mr Andrew Camilleri from BMI The Alexandra Hospital, answers some of the most commonly asked questions about tonsillectomy.
Tonsillectomy is an operation to remove the palatine tonsils, which are responsible for one of the most reasons for workers to go sick in the UK.
The tonsils can also be removed for snoring, sleep apnoea and nasal obstruction as well as to biopsy asymmetric ones. Finally the tonsils are removed in some cases of bad breath where there are deep pits with decaying food in the tonsils.
The procedure involves a general anaesthetic and a daytime stay in hospital. No food or drink should be eaten for six hours prior the anaesthetic. After the operation, the patient is allowed to go home when they are able to eat and drink. They will then take painkillers. It usually takes up to 10 days to recover from a tonsillectomy operation. The main side-effect is pain on swallowing and talking.
Recurrent courses of antibiotics are the only alternative to tonsillectomy. Patients usually try this before referral for the procedure. However, once they have had six attacks a year it becomes apparent that surgery may provide a more lasting benefit.
The main risk of tonsillectomy is a post-operative bleed. These usually occur within the first six hours and patients stay in hospital during that time. Approximately five days after the operation when the scab lifts off, there is a change of bleeding which is usually small.
Rare risks of tonsillectomy include damage to teeth and altered swallowing with fluid coming out of the nose in patients who have a sub-mucous cleft palate. The risks of a general anaesthetic is very small but in certain patients with medical problems, other precautions need to be taken.
The younger you are the quicker you recover. A 4 year old will usually have recovered within five days, whereas a 30 year old may take 10 days. Even after this time yawning may cause aching for up to 6 weeks.
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