Tonsillectomy - adult

Before you agree to have your tonsillectomy treatment for tonsillitis it is important to know all you can about the symptoms of tonsillitis, and about the treatment. The information here is a guide to common medical practice in the treatment of tonsillitis. Each hospital and doctor will have slightly different ways of doing things, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your tonsillectomy treatment choices with your doctors. You should mention any worries you have. Remember that you can ask for more information about tonsillectomy at any time.

What is the problem?

You are probably getting repeated infections in your tonsils. An infection of the tonsils is called tonsillitis. It is usually better to have your tonsils removed than to suffer repeated tonsillitis. Removal of the tonsils is called a tonsillectomy. Antibiotics are good for treating each attack of tonsillitis but will not prevent you from having more attacks in the future. If we remove your tonsils you will not have acute tonsillitis again.

What are the tonsils?

You can see your tonsils inside your mouth at the back of your throat. There is one on each side of the tongue behind the back teeth. The tonsils are made of lymphoid tissue, which helps the body fight infection. If you get a throat infection, the tonsils become swollen to fight the infection. When the infection has gone, they get smaller again.

There are other areas in the head and neck and all over the body made of lymphoid tissue, so without the tonsils the body can still fight infections.

What has gone wrong?

After repeated attacks of tonsillitis, the tonsils become scarred and remain enlarged. They may even keep infection trapped inside. In this state, the tonsils are no longer good at fighting infection and are best removed.

More tonsillitis may cause an abscess to form underneath one of the tonsils. This is called a quinsy and can be very painful.

The aims

The aim of a tonsillectomy operation is to completely remove both tonsils. This leaves two shallow troughs were the tonsils have come out. You will have a general anaesthetic and be unconscious for the operation.

The benefits

Without your tonsils, you cannot get tonsillitis again. You may still get mild sore throats due to the viruses that result in colds, coughs or the flu but these will not last very long.

Are there any alternatives?

There are no tablets or medicines that will permanently prevent tonsillitis. Antibiotics can make the tonsillitis better but if the tonsils are infected frequently, antibiotics may not work well. The only way to stop repeated attacks of acute tonsillitis is to remove your tonsils.

What if you do nothing?

You may continue to have tonsillitis. Your doctor can prescribe antibiotics to make the sore throat go away each time but this may take more than one course of tablets.

Who should have it done?

You should have your tonsils removed if you are:

• having five or six attacks of acute tonsillitis each year
• very ill with each attack
• off work a lot.

Who should not have it done?

People who have medical conditions that would make it unsafe to have a general anaesthetic should not have one. There are also specific medical situations when a tonsillectomy should not be done. These are:

• when taking medication that prevents your blood from clotting, such as Warfarin
• when you have an illness that prevents your blood from clotting, such as haemophilia.

Both these situations would lead to more bleeding than normal. If you think either of these applies to you, inform your doctor. They will take a blood sample to test the clotting of your blood.

Author: Mr Robert Ruckley MB. ChB.  F.R.C.S.  Consultant ENT surgeon.

© Dumas Ltd 2006

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