Mr ENYI OFO
Consultant ENT, Head & Neck, Thyroid and Parathyroid Surgeon
BSc (Hons) MBBS (Lond) DO-HNS FRCS (ORL-NHS) PhD
The tonsils are two small almond shaped lymphatic glands located on either side of the back of the throat. They are there to help fight infections in children however as we get older, they become less important and can often shrink in size.
Tonsillitis is a term used to describe an infected tonsil which can cause pain, fever and difficulty swallowing. This can make you unwell if untreated, and usually requires a short-term course of antibiotics plus regular analgesia.
INDICATIONS FOR TONSILLECTOMY
The tonsils should be removed if you get recurrent episodes of tonsillitis with a defined period of time that affects day to day life, or if tonsils are too large and cause difficulty swallowing, causes snoring, or difficulty breathing at night. Tonsils should only be removed if they are causing more harm than good.
ALTERNATIVES TO SURGERY FOR CHILDREN WITH TONSILLITIS
Tonsillectomy is one way of permanently resolving the problem of regular pain, discomfort, and disruption to schooling plus day to day activities, associated with recurrent tonsillitis. You may want to wait a year to see if your child grows out of getting regular tonsillitis, as sometimes it may improve without surgical intervention. Alternatively, a longer course of antibiotics may help, however long-term use of antibiotics is not advisable as they can cause other problems.
WHAT DOES THE OPERATION INVOLVE?
The operation is performed under a general anaesthetic and usually takes between 20 to 30 minutes. Your surgeon will perform the tonsillectomy through the mouth. They will cut or peel the tonsil away from the layer of muscle underneath it (tonsil bed), using heat or radio-frequency energy to remove the tonsil and cauterise areas of the tonsil bed if required to stop any bleeding.
WHAT COMPLICATIONS COULD HAPPEN?
Tonsillectomy is safely performed in the vast majority of patients, however, every operation has a small chance of complications. General Complications
• The most serious complication is bleeding in about 10% of patients, and a second operation may be required in a small number of these patients to stop the bleed. Let us know if anyone in your family has a history of bleeding.
Pain. This is a recognised post-operative outcome following tonsillectomy. Pain can usually be controlled in most patients with suitable analgesia, and always settles after 1 to 2 weeks.
Infection at the surgical site (wound)
During the anaesthetic, there is a small chance that the anaesthetist may chip or knock out a tooth, especially if it is loose, capped or crowned. This could also occur when the surgeon is placing instruments through the mouth whilst performing the procedure.
Tonsillectomy is usually performed as a day case procedure and patients will be able to go home on the day of surgery as long as they are eating and drinking well enough. The pain after tonsillectomy can last for up to two weeks and tends to be worse first thing in the morning. It is advisable to take regular painkillers as advised by your surgeon at least half an hour before meals for the first week.