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Tonsillectomy

Surgery Overview

A tonsillectomy is the surgical removal of the tonsils. The adenoids may or may not be removed at the same time. Adenoidectomy is not discussed in this topic. For more information, see the topic Ear Infections.

A general anesthetic is always used to sedate a child having a tonsillectomy. Adults may require only a local anesthetic to numb the throat.

What To Expect After Surgery

The surgery may be done as outpatient surgery or, sometimes, during an overnight hospital stay.

A very sore throat usually follows a tonsillectomy and may last for several days. This may affect the sound and volume of the person's voice and his or her ability to eat and drink. The person may also have bad-smelling breath for a few days after surgery. There is a very small risk of bleeding after surgery.

A child having a tonsillectomy may feel "out of sorts" for a period of a week to 10 days. But if the child is feeling well enough, there is no need to restrict his or her activity or to keep the child at home after the first few days.

Why It Is Done

A tonsillectomy may be done in the following cases:

  • A person has ongoing or recurring episodes of tonsillitis.
  • A person has recurring episodes of strep throat in a single year despite antibiotic treatment.
  • Abscesses of the tonsils do not respond to drainage. Or an abscess is present in addition to other indications for a tonsillectomy.
  • A persistent foul odor or taste in the mouth is caused by tonsillitis and does not respond to antibiotic treatment.
  • A biopsy is needed to evaluate a suspected tumor of the tonsil.
  • Especially in children, the tonsils are so large they affect nighttime breathing, called sleep apnea.

Large tonsils are not a reason to have a tonsillectomy unless they are causing one of the above problems or they are blocking the upper airway, which may cause sleep apnea or problems with eating.

How Well It Works

Children whose tonsils are removed for recurrent throat infections may have fewer and less severe strep throat infections for at least 2 years. But over time many children who do not have surgery also have fewer throat infections.1

Adults who have their tonsils removed after repeated strep throat infections don't get as many new infections as adults who do not have the surgery. And adults who had the surgery also don't get sore throats as often.2

Risks

Normal or expected risks of tonsillectomy include some bleeding after surgery. This is common, especially when the healed scab over the cut area falls off.

Less common or rare risks include:

  • More serious bleeding.
  • Anesthetic complications.
  • Death after surgery (very rare).

What To Think About

When you are trying to decide whether to have the tonsils removed, you might want to think about:

  • How much time a child is missing from school because of throat infections.
  • How much stress and inconvenience the illness has on the family.

The risks of surgery must also be weighed against the risks of leaving the tonsils in. In some cases of persistent strep throat infections, especially if there are other complications, surgery may be the best choice.

Some people think that removing the tonsils may hurt the body's immune system, but research does not support this.

Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.

References

Citations

  1. Paradise JL, et al. (2002). Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children. Pediatrics, 110(1): 7–15.
  2. Alho OP, et al. (2007). Tonsillectomy versus watchful waiting in recurrent streptococcal pharyngitis in adults: Randomised controlled trial. BMJ. Published online March 8, 2007 (doi: 10.1136/bmj.39140.632604.55).

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Charles M. Myer, III, MD - Otolaryngology
Last Revised December 8, 2010

Last Revised: December 8, 2010

Author: Healthwise Staff

Medical Review: Kathleen Romito, MD - Family Medicine & Charles M. Myer, III, MD - Otolaryngology

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