ENT West

Operations

Tonsillectomy

We have two palatine tonsils at the back of the throat made of lymphoid tissue. These contain cells from the immune system but there are many other areas in the body that contain similar tissue. If the tonsils become recurrently or chronically infected then it may be in the adult or child’s best interest to have the tonsils removed. Currently, we use the SIGN guidelines to establish whether a patient may require a tonsillectomy for treatment of recurrent infections. Tonsils are also removed if the individual has significant problems with breathing, particularly at night. This is called obstructive sleep apnoea. Enlarged tonsils in this situation are often found in conjunction with enlarged adenoids. Rarely, we take tonsils out because of recurrent abscess or when a tumour is suspected. The operation involves a general anaesthetic and the tonsils are removed through the mouth. Bleeding is usually minimal. Postoperatively there is a small risk (1-2%) of bleeding in the hours immediately following the operation and so the patient is carefully monitored at this time. In general patients are usually allowed home the next morning if they are eating and drinking well. After tonsillectomy the areas where the tonsils have been removed become white. This is normal. The white areas will take two weeks approximately to disappear. Patients often experience quite marked pain in their ears and this is quite normal. This is called referred pain and it is not because of infection in the ears. Often quite strong painkillers are required. Painkillers should be taken regularly and also particularly before meals so that normal oral intake can continue. Antibiotics are sometimes given to prevent post operative infection but not as a routine. Patients should remain away from groups of people for two weeks to try and avoid picking up an infection. They can mix with family and close friends and can go outdoors. There is a risk at five to ten days after the operation of developing a throat infection and subsequent bleeding. In this event you should seek the advice of a doctor and if bleeding continues the patient should be taken directly to the nearest accident and emergency department.

 

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