Tonsillectomy

The tonsils (palatine tonsils) are made up of soft tissue and are located at the back of the throat (pharynx), with one on each side. The tonsils play a role in protecting the body against respiratory and gastrointestinal infections. Removal of the tonsils does not seem to increase the likelihood of infection.

Tonsils vary in size and appear useless, though actually have several functions. The tonsils prevent objects from slipping into the lungs; they also contain white blood cells that filter bacteria and viruses.

There are 3 different types of tonsils:

• Palatine tonsils (tonsilla palatina)
• The adenoids (pharyngeal tonsil or tonsilla pharyngealis)
• Lingual tonsil (tonsilla lingualis)

The two palatine tonsils are located on either side of the throat, and are the only tonsils that can be seen unassisted when you open your mouth. The adenoids are found further up, behind the nose, and can only be seen through close inspection (rhinoscopy, an examination of the inside of the nose). The lingual tonsil is situated at the back of the tongue.

The palatine tonsils can become inflamed. Known as tonsillitis, this makes them swell up and turn very red, causing pain, fever, and can make swallowing difficult. Surgery is recommended to treat tonsillitis as it is the only dependable way to prevent the condition recurring. The tonsillectomy procedure is a surgical operation to remove infected tonsils

Causes of Tonsillitis

The tonsils’ main function is to fight bacteria and viruses that enter your body through your mouth and nose, though they are also vulnerable to infection. Viral infection is the most common cause of tonsillitis, though bacterial infections can also be the reason.

Viral tonsillitis is typically caused by a cold, but may also be due to other viruses such as the flu virus.

Bacteria causes around 1 in every 3 cases of tonsillitis with most bacterial tonsillitis being caused by ‘strep throat’ (an infection in the throat and tonsils caused by a bacteria called group A streptococcus that can cause inflammation, pain and fever).

Streptococcal tonsillitis is most common in children aged between 5 and 15. Viral tonsillitis is more common in younger children.

Symptoms of Tonsillitis

Tonsillitis and strep throat have many similar symptoms.  This is because strep throat can be considered a type of tonsillitis.  These symptoms include:

• Discomfort when swallowing
• Coughing
• Sore throat (loss of voice)
• Earache
• Fatigue
• High temperature (over 38°C)
• Bad breath
• Headache
• Feeling nauseous or vomiting (particularly in children)
• Stomach pain (particularly in children)

Severe symptoms can include:

• Swollen, painful glands in your neck (lumps on the side of your neck)
• White pus-filled spots on the tonsils at the back of your throat

A tonsillectomy can also be used to treat other medical conditions, including persistent loud snoring, breathing issues, bleeding of the tonsils, glandular fever and other rare tonsil diseases.

Diagnosis of Tonsillitis

Tonsillitis typically recovers on its own within a week without any medical assistance. You can use over-the-counter medicines to ease your symptoms; however, if your symptoms are not improving after a week, or are getting worse, you should seek medical help.

Your doctor will ask you to describe your symptoms and usually be able to diagnose from the visible signs without having to do any further tests.

They may look inside your mouth and wipe a cotton bud at the back of your throat to check for bacteria, possibly feeling around your neck to check for swollen glands.

As the symptoms of tonsillitis are similar to those of glandular fever, they may also organise a blood test to eliminate it as a cause. You will get the results of your test within a couple of days.

Treatment

Tonsillectomy surgery is an option for people who repeatedly suffer with tonsillitis or strep throat. Tonsillectomies are more common in children than adults, although people of any age can experience symptoms resulting in the procedure.

If you are someone who suffers from repeat tonsillitis, a tonsillectomy will stop further occurrences. You may still suffer from sore throats, but they should not arise as often. If you choose not to have your swollen tonsils removed, you can develop other problems including abscesses forming, a fever, or breathing difficulties.

The tonsillectomy procedure is a surgical operation for removing the palatine tonsils, most commonly carried out on teenagers. Performed on a day case basis the operation takes roughly 30 minutes and is performed under general anaesthetic (you will not be awake or feel any pain). As the surgery is performed under general anaesthetic, you will need to arrange for travel home following the operation.

There are several methods for carrying out a tonsillectomy procedure:

Cold Steel Dissection

The most common method of tonsil removal is cold steel dissection where the tonsil is cut away using a scalpel blade or surgical instrument.

Cauterisation

A hot tonsillectomy uses a surgical device where a safe electric current is sent to the needle tip; this seals the blood vessels as they are cut.

Ultrasonic vibrations

This procedure uses ultrasonic energy to dissect through the tissue and seal the blood vessels.

During the operation, your surgeon will cut the tonsil away from the muscle that supports it and use heat to cauterise the area, or radio-frequency energy to dissolve the tonsil.

In children, the doctor may recommend antibiotics before advising surgery as a long course may be effective in breaking the cycle of frequent infections. In adults, however, antibiotics are unlikely to be effective, especially following glandular fever.

Post-Operative Recovery

Patients who undergo the tonsillectomy procedure should be able to return home on the same day unless your doctor recommends you stay overnight. You may need pain relief to ease discomfort and pain as the anaesthetic begins to wear off.

Pain from the operation may increase in the first few days and can last for roughly 2 weeks. It is generally worse first thing in the morning, experienced frequently in the ears and throat, and it can affect the jaw and neck, before gradually improving. You may feel tired for the first few days so make sure you rest as much as you can following the procedure, and be aware that snoring in the first couple of weeks is completely normal.

You will need to stay away from school, work, or groups of people during the recovery process but can return to work (job dependent) within 3 days. Rest, pain relief, liquids and regular exercise should help you recover as fast as possible. Before beginning a course of exercise, consult your medical team for advice. Keeping your fluids up is important to avoid dehydration along with plain foods that are easily swallowed.

Complications from Tonsillectomy 

Tonsillectomy is generally a minor, low risk procedure but as with any surgery there is always the possibility of complications.  Possible complications following a tonsillectomy include:

Bleeding

You may bleed within the first couple of weeks following the operation. In extremely rare cases, you may need a second operation to stop the bleeding.
Infection. Bleeding after surgery can sometimes be a sign of infection.

Dehydration

Common signs of dehydration include reduced urination, thirst, weakness, headache and dizziness.

Breathing problems

Due to swelling in your throat or inhaling blood or bits of tissue during the operation.

Damage to your teeth

This is more likely to occur if your teeth are loose, capped or crowned and is generally caused by the equipment that keeps your mouth open during surgery.

Possibility that the tonsils can grow back

Although rare, sometimes surgery does not remove them properly, meaning they may grow back again.

A follow-up appointment for a check-up should be made 10 to 14 days after the procedure, although call the hospital before the 10 days if you are worried about complications.

Outlook after a Tonsillectomy

Tonsillectomy surgery tends to improve the long-term quality of life whilst reducing medication and missing fewer workdays due to a repetitive sore throat. Although it does not eliminate a sore throat entirely, most who have a tonsillectomy have fewer throat infections in the future.

Need Help?

At One Healthcare we can book you in to see a specialist Ear, Nose and Throat surgeon for an initial consultation, usually within 48 hours.  The private tonsillectomy procedure is available at One Ashford Hospital in Kent and One Hatfield Hospital in Hertfordshire.

You can use your private medical insurance or pay for your Tonsillectomy treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.

Why One Healthcare

• Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• 0% and low finance options**
• Private, spacious, en-suite rooms
• Specialist Physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

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