Tonsillectomy In Adults: Procedure, Benefits & Recovery

By Author: arfa malik
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Tonsillectomy is a surgical procedure whose objective is the partial or total removal of the tonsils. The palatine tonsils, or amygdalae, are two small glands of lymphoid tissue that play an immune role. They are part of a vast network of lymphoid tissue distributed throughout the lining of the pharyngeal cavity (the back of the throat) and also along the digestive system. The tonsils are located at the back of the throat, on either side of the soft palate. The palatine tonsils play a role in the production of lymphocytes and antibodies, which help fight infections. Significant tonsil development is frequently observed in children aged 3 to 5, but this is physiological. It indicates that the child is developing their immunity, and the volume of the tonsils normally decreases naturally after age 5. In some cases, however, persistent infections or breathing difficulties may lead to the need for a tonsillectomy in adults.

The adenoids are lymphoid tissue

The adenoids are lymphoid tissue located in the pharynx, at the back of the nasal cavity. Adenoid hypertrophy is often present alongside tonsillar hypertrophy. In ...
... children, adenoid removal ( adenoculectomy ) is often performed at the same time as tonsillectomy. The primary indication for tonsillectomy is obstructive sleep apnea ( OSA ), which affects between 1% and 3% of children between the ages of 3 and 6, and 13% in cases of obesity. Allergies can contribute to tonsillar hypertrophy. The classic indications for tonsillectomy are obstructive sleep apnea, recurrent tonsillitis (more than 5 episodes in 2 years), and a history of peritonsillar abscess. Chronic obstructive sleep apnea is the most frequent cause of tonsillectomy. Less commonly, the indication is for recurrent fevers ( Marshall syndrome ), or deep abscess of the neck ( adenophlegmon ), or even acute obstruction during mononucleosis.
What is the benefit of a second opinion for a tonsillectomy?
Why seek a second opinion for a tonsillectomy?
Tonsillectomy is an operation that can lead to complications; it should not be performed routinely. It is essential to ensure that the indication is appropriate, that the medical history is consistent, and that the anatomical context has been thoroughly analyzed, taking into account risk factors (blood disorders, malformation syndromes, etc.). Medical alternatives should be discussed. Furthermore, two surgical techniques exist. A second opinion helps to verify the relevance of the operation and to ensure that the chosen technique is indeed the most appropriate, thus improving the prognosis for patients.
What are the most frequently asked questions?
What diseases are eligible for tonsillectomy?
The indications for a tonsillectomy are:
Infections
Recurrent acute tonsillitis (at least 3 infectious episodes/year for 3 years or 5 episodes/year for 2 years), chronic infection of more than 3 months resistant to medical treatment ( pharyngeal pain, halitosis = bad breath, inflammatory appearance of the tonsils, and cervical lymphadenopathy ), and peritonsillar abscesses.
An obstruction
If excessive development of the tonsils is observed ( tonsillar hypertrophy ), the airway is obstructed, especially during sleep, due to the relaxation of the jaw and tongue muscles. This will lead to obstructive sleep apnea syndrome, characterized by poor sleep quality, with restlessness and night sweats, bedwetting, nightmares, fatigue upon waking, difficulty eating solid foods, weight loss and thinness, or conversely, paradoxical obesity, irritability, memory problems, etc. Adenoid hypertrophy, which is often associated with this condition, should also be investigated.
Other pathologies
Periodic fever syndrome (a syndrome causing a general inflammatory reaction)
Cancer
An asymmetrical, rapidly evolving appearance of the tonsil should raise suspicion of cancer or lymphoma and requires urgent intervention.
What happens during a tonsillectomy?
Tonsillectomy is an operation performed under general anesthesia. Tracheal intubation (insertion of a tube into the trachea) is performed to isolate and protect the upper airway during ventilation. There are two main surgical techniques: total excision surgery and partial surgery.
The first technique involves removing the entire tonsil, including its muscular border (extracapsular). Bleeding is controlled with small cauterization stitches or, in cases of difficult-to-control bleeding, with localized sutures. The second technique involves removing a portion of the tonsillar tissue, remaining within the capsular border, and leaving a small amount of tonsillar tissue along the surrounding tissue. This section is performed using a radiofrequency probe, which allows for thermal cutting and minimizes bleeding and postoperative pain. Total tonsillectomy is most often recommended in cases of repeated infections, or a history of phlegmon (abscess) of the tonsil. Partial surgery is offered in cases of obstructive sleep apnea syndrome. Surgery is generally performed on an outpatient basis except in specific cases. Soft foods can be reintroduced the same evening.
What follow-up is needed after a tonsillectomy?
After the operation, bleeding is possible, particularly in the following two weeks. A follow-up appointment with the surgeon is therefore necessary to confirm complete healing. Following the procedure, regardless of the technique used, pain medication and antibiotics are prescribed. Good hydration and oral hygiene also promote healing.
What are the benefits and risks of a tonsillectomy?
The indications for tonsillectomy are limited and well-defined. Currently, obstructive sleep apnea syndromes are the leading cause of surgery in children, and the results are significant, even spectacular. However, it is essential to confirm that the tonsils are indeed the cause of the obstruction (by checking the adenoids and looking for other malformations). In cases of recurrent infections with acute tonsillitis, tonsillectomy is also effective, but these episodes must be documented, and it is sometimes difficult to differentiate between tonsillitis and pharyngitis.
Total tonsillectomy does not prevent the occurrence of pharyngitis (inflammation of the pharyngeal lymphoid tissue).
What are the risks of a tonsillectomy?
The surgical area typically heals within eight to fifteen days. Soreness in the throat, ears, and mouth is common after the operation (usually lasting between five and fifteen days). Consuming acidic, hot, or spicy foods can worsen this pain. The main postoperative risk of tonsillectomy is bleeding, which is most likely within the first six hours after surgery. Bleeding can also occur as the scab detaches and the wound heals, which takes ten to fifteen days.

Partial surgery is relatively painless, and the risk of bleeding is limited. However, postoperative monitoring is necessary for about two weeks. Before surgery, it is necessary to ensure that there is no specific complex context that should require further advice and/or documentation of the indication (sleep recording in case of obstructive sleep apnea syndrome): allergy/asthma, blood disease, coagulation disorders, cardiac involvement, etc. If you are experiencing persistent throat pain or recurrent tonsillitis, consulting an experienced ENT specialist West Yorkshire can help determine whether a tonsillectomy is the right treatment option for you.