Recurrent tonsillitis occurs not only in childhood but also in adults. In such cases, tonsillectomy in adults may be considered, as surgery can help prevent recurring tonsillitis. However, it carries certain risks, primarily postoperative bleeding. Inflammation of the palatine tonsils can lead to symptoms including a sore throat and difficulty swallowing. The cause is often initially attributed to antibiotics. If the tonsils become inflamed repeatedly, the question may arise whether it would be better to have them partially or completely removed. This involves weighing the pros and cons: On the one hand, there is the hope that inflammation will occur less frequently or not at all after surgery. On the other hand, there are risks associated with the procedure and the question of whether it can actually provide lasting relief.
The virus causes tonsillitis
Furthermore, it should be ruled out, if possible, that a virus causes the tonsillitis. These are not always easy to distinguish from bacterial tonsillitis. However, bacteria can be detected by a throat swab.
- If bacterial tonsillitis occurs at least three to five times per year.
- Repeatedly took an antibiotic and
- The symptoms are very distressing.
Typical symptoms of bacterial tonsillitis include:
- Fever (over 38°C)
- swollen and painful neck lymph nodes
- Purulently coated almonds
- no cough
Last but not least, complications such as a build-up of pus around the tonsils (Peritonsillar abscess) can be a reason to consider surgery.
What are the benefits of a tonsillectomy?
A complete removal of the tonsils (tonsillectomy) can help reduce the frequency of sore throat infections. While the palatine tonsils can no longer become infected, other tissue in the throat may become inflamed. Two small studies indicate that adults experience fewer sore throats after tonsillectomy. However, since the studies only lasted six months, it’s impossible to say precisely how significant the long-term benefits of tonsillectomy are. The studies showed:
Without surgery: The study participants had approximately 2 to 7 episodes of sore throat in the six months following the start of the study.
With surgery: The participants who underwent surgery experienced approximately one episode of sore throat in the six months following the procedure. Depending on the study, they were also ill for 10 to 35 fewer days than the participants who did not undergo surgery.
The benefit of surgery depends on the severity of the symptoms and whether the inflammation originates from the tonsils or the surrounding tissue.
What are the reasons against surgery?
Tonsillitis may become less frequent over time, even without surgery. This is unpredictable. However, it’s advisable not to rush into surgery but to wait and see if the problems subside. If they don’t, surgery can still be considered. The first few days after a tonsillectomy are often uncomfortable because the wound can be painful, and swallowing may also be difficult. The discomfort may subside after a few days, but sometimes it can last for one to two weeks. Temporary nausea and vomiting, difficulty swallowing, and taste disturbances can occur. Complications such as bleeding are also possible. Some people fear that removing the tonsils will immune system. They may weaken the immune system and, for example, increase the risk of respiratory infections. However, whether this is true is not scientifically established. The tonsils do play a more important role in the immune system during the first years of life than later on.
What complications can result from a tonsillectomy?
The wound may bleed again after the operation. Such bleeding usually occurs within the first week after the procedure, but it is possible for up to four weeks afterward. Warning signs include frequent swallowing and blood in the saliva. The blood may also enter the trachea or be vomited up. Because post-operative bleeding can lead to significant blood loss, it is considered an emergency. Therefore, it is crucial to go to the hospital immediately or call emergency services on 112. While bleeding sometimes stops on its own, blood transfusions and possibly further surgery may be necessary. The risk of postoperative bleeding depends, for example, on the surgical procedure, age, and whether there is an increased tendency to bleed. Studies show:
- About 5 out of 100 adults experience post-operative bleeding.
- Approximately 1 in 5 of these adults will undergo surgery again.
- The voice may temporarily sound nasal. Sometimes food or liquid may come out of the nose. However, this usually subsides after a few days to weeks.
Like all surgeries, a tonsillectomy carries general risks such as impaired wound healing, infections, or side effects of the procedure. anesthesia.
What is the procedure for a tonsillectomy, and what methods are available?
The procedure usually takes place in a hospital and lasts 15 to 30 minutes. It is a general anesthetic necessary. Afterward, you stay in the clinic for several days. There are many different methods for removing the tonsils. Broadly speaking, there are two main procedures:
Tonsillectomy: The tonsils are completely removed. This requires a hospital stay.
Tonsillotomy: The tonsils are partially removed. This procedure can alsooutpatientoffered.
In addition, there are various surgical techniques:
Procedures involving heat generation (diathermy): In this procedure, the tonsils are removed using a radiofrequency device or laser. Both devices generate intense heat that directly seals the wound. Other methods use less intense heat (so-called coblation).
Procedures without heat generation (dissection): In this procedure, the tonsils are removed using instruments such as scissors or a loop.
Which is better: a partial or a complete tonsillectomy?
Partial tonsillectomy (tonsillotomy) is somewhat gentler because less tissue is removed, and the wound remains smaller. In the days following this procedure, there is significantly less pain, and patients can resume eating sooner than after a complete tonsillectomy. Furthermore, the risk of post-operative bleeding is likely lower. However, it is unclear how effectively partial tonsillectomy can prevent recurrent tonsillitis. There are currently very few studies that have examined the effectiveness of partial tonsillectomy compared to complete tonsillectomy. Therefore, statutory health insurance companies generally do not currently reimburse tonsillotomy as an outpatient procedure. In cases of frequently recurring bacterial tonsillitis, doctors usually suggest removing the tonsils completely (tonsillectomy).
How can I alleviate the discomfort after surgery?
Pain is the most bothersome symptom after a tonsillectomy. It usually subsides after a few days. Until then, pain-relieving medications in the form of tablets, suppositories, drops, infusions, or sprays can help. Medications are also available for nausea and vomiting. Certain behaviors can help speed up recovery and reduce the risk of post-operative bleeding. It is recommended to take it easy physically in the first few days after surgery: for example, avoid lifting heavy objects and wait a few weeks before resuming sports activities. Hot showers and very warm baths are discouraged. It is also advisable to eat only soft foods initially to protect the wound. Spicy ingredients and acids, including fruit juices and citrus fruits, can irritate the wound. This also applies to gargling with mouthwash.
How can a second opinion help?
Whether a tonsillectomy is advisable depends on various factors: How frequently do inflammations occur? How severe are the symptoms? What are the chances of success of the procedure? How likely is it that tonsillitis will become less frequent even without surgery? Doctors may give different recommendations. If a tonsillectomy is recommended, the doctor must inform you of your right to seek a second opinion – that is, to consult another doctor at a different practice or clinic. You can also book a consultation with an ENT doctor West Yorkshire to discuss whether tonsillectomy is the right option for you. Our decision aid, which briefly summarizes the main advantages and disadvantages of the treatment options, can also be used to support you in this process.
Schedule an appointment today with a trusted ENT specialist in West Yorkshire to get personalized advice on your tonsillectomy options.