When do adults need their tonsils removed?

Skip subnavigation.

Keyword

Receive the Summa Health eNewsletter for the latest health tips, advice and updates.

Related Content

Tonsil Cancer

Posted August 09, 2021 by Ryan Gerritsen, M.D.

Tonsillectomies are common surgeries performed on children. But sometimes adults can benefit from having their tonsils removed, too.

Tonsils are two oval-shaped clumps of tissue that sit in the back of your throat to trap germs that enter your body through your mouth or nose. Because they are your immune system’s first line of defense against bacteria or viruses, they are particularly vulnerable to infection and inflammation. This can cause recurring sore throats, snoring and other chronic problems.

Summa Health describes a few situations that may require a tonsillectomy as an adult.

Sore Throat

One of the most common reasons for a visit to your primary care provider is a sore throat. The most likely reasons your physician may recommend a tonsillectomy are frequent, severe sore throats or a chronic infection in your tonsils.

However, if you have infrequent, uncomplicated infections, your doctor will probably just treat you as needed.

Abscess on your Tonsils

If you experience severe pain, fever, significant bulging around your tonsils, pain when you open your mouth or you notice your uvula is shifted to one side, you may have an abscess on your tonsils and should seek medical attention immediately.

While it is typically treated with antibiotics and drainage, 10 to 15 percent of the time the abscess returns, prompting some clinicians to recommend tonsillectomy early in the course of treatment, rather than waiting for it to come back.

Sleep Apnea

If your tonsils are enlarged, they may actually obstruct your airway when you lie down and cause you to temporarily stop breathing in your sleep, a condition known as sleep apnea. You could wake up in the middle of the night gasping for breath.

Chances are, if you have sleep apnea, you may have been told that you snore loudly, as well. However, loud snoring does not necessarily mean you have sleep apnea.

If it’s suspected enlarged tonsils are the cause of your sleep apnea, your physician may recommend a tonsillectomy.

One Big Tonsil

If one of your tonsils is much larger than the other, your doctor may recommend a tonsillectomy as a precaution to rule out serious underlying causes.

Surgery is typically recommended only if you have other related symptoms, such as difficulty swallowing, persistent pain, swelling of the glands in your neck, or one tonsil that keeps getting larger and larger over time. The good news is most of the time, having one enlarged tonsil is simply due to a minor issue.

If you’re concerned about your tonsils, schedule an appointment with one of our ear, nose and throat (ENT) specialists to discuss your symptoms.

Signs It’s Time for a Tonsillectomy

By Amit Patel, M.D.

Your tonsils play a role in your immune system, however – for some – tonsils can seem to cause more harm than good. If you’re someone who frequently gets severe, painful sore throats, you may be wondering whether you should consider having surgery to remove your tonsils. This type of surgery is known as a tonsillectomy.

While tonsillectomies are more common for children, there are times when an adult should consider getting a tonsillectomy for recurrent infections. It’s important to listen to your body and see a doctor when you’re experiencing certain symptoms.

If you’re experiencing one or more of these symptoms, you should consider seeing your primary care physician for evaluation:

• Severe throat pain
• White spots on your tonsils
• Painful or difficulty swallowing
• Fever
• Swollen, tender lymph nodes in your neck

If your physician runs a test and the results show an infection, it’s important to then remain mindful of how often you’re experiencing these infections. That rate will help us determine if you are in need of a tonsillectomy.

Here is the criteria for tonsillectomies, which you’ll see is linked to the rate of infection:

1. You’ve had seven or more episodes of documented bacterial tonsillitis in a year.
2. You’ve had five or more episodes per year of documented bacterial tonsillitis over the course of two consecutive years.
3. You’ve had three or more episodes per year of documented bacterial tonsillitis over the course of three consecutive years.

In addition to using that rate-of-frequency criteria, we will also take into consideration how much a person’s life is being affected by their tonsils. It is common to have a patient who comes in and reports that the enlarged size of their tonsils are causing issues with sleep apnea, swallowing and/or unwanted weight loss. This should always be reported to your physician.

Tonsillectomies for Adults Versus Children

Are tonsillectomies more painful for adults than children? The truth is the procedure itself is essentially the same for adults as it is for children. The recovery for adults tends to be more prolonged than it is for children. For adult patients, it can take about two weeks for patients to recover as the area needing to heal is larger. For children, they tend to get less sore following surgery and are usually back on their feet more quickly – often within one week.

For adults and children alike, following the procedure it’s usually recommended that the patient use pain medication, like Advil or Tylenol, to get the pain down to a dull ache. Recovery recommendations also include making sure you’re getting plenty of fluids after surgery, consuming foods that are easy to swallow – like pudding or Jell-O – and avoiding any strenuous activities.

The most worrisome complication of a tonsillectomy is to have bleeding after the operation. The tonsillectomy bed heals from a raw muscle bed and the soft scabs that form over this area tend to fall off after 5-7 days. During this time is when patients are at the highest risk of bleeding. The rate of bleeding after tonsillectomies varies in studies, but about 5-15 percent of patients bleed after a tonsillectomy. This can range from a small amount of bleeding which stops spontaneously, up to heavy life-threatening bleeding coming from the mouth which would need to be cauterized in the operating room. Fortunately, life-threatening bleeding after a tonsillectomy is rare.

Common Misconceptions

A common misconception is that, once a patient has a tonsillectomy, they will never get strep throat – or a sore throat at all – again. Unfortunately, it still is possible to get sore throats after a tonsillectomy. The good news is the surgery has proven to reduce the frequency and severity of sore throats and throat infections.

Next Steps & Resources

• Meet our clinical contributor: Amit Patel, M.D.
• To make an appointment with Dr. Patel or another physician, call 800-822-8905 or visit our website

Sources:

• American Academy of Family Physicians
• Faramarzi A, Heydari S. -T. (2010). Prevalence of post-tonsillectomy bleeding as day-case surgery with combination method;cold dissection tonsillectomy and bipolar diathermy hemostasis. Iranian Journal of Pediatrics.

The material provided through Health Hub is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

Removal of plugs from the tonsils – what is it and how is the procedure, types of plugs in the tonsils and methods for their removal

The palatine tonsils (tonsils) are a collection of lymphoid tissue located on either side of the entrance to the pharynx. They are an important part of the immune system and serve as a kind of barrier that prevents infection from entering the respiratory tract. The surface of the tonsils has a large number of folds (crypts and lacunae), which significantly increase the area of ​​the mucous membrane. This is necessary to enhance the protective function of formations.

In some people, dead and living bacteria, leukocytes, waste products of microorganisms, and food debris accumulate in the depths of the crypts. The result is a plug that looks like a whitish or yellowish formation.

Why do throats get blocked

The main cause of congestion is chronic tonsillitis. As a rule, it is a complication of angina and occurs when the doctor’s recommendations are not followed, for example, if the antibiotic regimen is violated. Also, the problem may occur in the background:

• mechanical damage to the tonsils with food;
• individual features of the structure of the tonsils, as a result of which the process of their self-purification is disturbed;
• weakening of local immunity in the oral cavity, for example, against the background of dental diseases, smoking, etc.

What are the dangers of plugs in the tonsils

Plugs in the tonsils are not just an accumulation of pathological contents. They are a suitable medium for microorganisms, including hemolytic streptococcus. Microbes can exist for a long time in a filled crypt. A decrease in local immunity contributes to the development of the inflammatory process. In this case, the infection can capture not only the tonsils themselves, but also other structures: the middle ear, the maxillary sinus, etc. That is why it is very important to remove the plugs in a timely manner. The sooner the patient turns to the ENT, the easier it will be to cope with the formations.

Signs of congestion in the throat

In most cases, plugs are clearly visible when examining the oral cavity. They look like light spots on the pink surface of the tonsils. The size of the formations can vary from 1-2 mm to a centimeter. In some patients, single plugs are detected, in others they cover almost all the tonsils. The arches, as a rule, thicken, and the tonsils themselves become loose and increase in size. With a significant number of formations, the patient also complains of bad breath. With the activation of the inflammatory process in a person, the temperature rises, there is a sore throat and discomfort during swallowing. The appearance of these symptoms requires the help of an ENT doctor.

Methods of treatment of chronic tonsillitis

Exacerbation of chronic tonsillitis is treated similarly to any inflammatory process in the pharynx and tonsils. The patient is assigned:

• antibacterial preparations;
• antiseptic sprays and rinses;
• anti-inflammatory and analgesics;
• fever reducers.

Depending on the situation, the treatment regimen can be supplemented with physiotherapy, drugs to stimulate the immune system, etc. When the inflammatory process is eliminated, the question is raised about the removal of purulent plugs from the tonsils.

Methods for removing purulent and food plugs from the tonsils

Otolaryngologists use two methods for removing plugs: with a syringe and using the Tonsillor apparatus. In the first case, the doctor uses a regular syringe filled with water or an antiseptic solution. A special cannula (flexible tube) is put on his nose, which is brought to the problem area. A jet of liquid is applied to the cork, the pressure of which washes away the accumulated pathological contents. The procedure is repeated until the surface is completely clean.

The device “Tonsillor” allows you to clean using ultrasonic waves. The working nozzle is made in the form of a small cup. It delivers ultrasound to the surface of the tonsil and immediately sucks the contents of the gaps. This technology allows you to quickly clean and further stimulate tissue regeneration. To date, Tonsillor is gradually replacing the classical technique.

Blockage Prevention

To reduce the risk of blockages on the tonsils, you must:

• carefully follow the doctor’s recommendations when treating angina;
• timely treat caries and other inflammatory diseases of the teeth and surrounding tissues;
• monitor oral hygiene;
• do not use other people’s toothbrushes, etc.

It is very important not to try to remove the plugs yourself. Neither cotton swabs, nor toothpicks, nor fingers are suitable for this procedure. Such manipulations can injure the delicate tissue of the tonsil and cause a strong inflammatory process. It is better to contact an experienced ENT, who will choose the appropriate treatment method.

A 20-year-old girl died in Tambov after an operation to remove her tonsils — Novy Tambov
New Tambov

28
121

53 371

Relatives and friends of the deceased Kristina Popova are sure that the cause of the tragedy was a medical error and the negligent attitude of doctors towards the condition of the girl after the operation. At the moment, on this fact, the Investigative Committee of the Tambov Region has begun an investigation. Relatives of Kristina Popova told the correspondent of “New Tambov” about how events unfolded in this tragic week for them.

Kristina Popova

Tambov resident Kristina Popova was admitted to the ENT department of the third city hospital on July 11th. She had a planned and essentially banal operation to remove the tonsils. The medical record included a diagnosis of chronic tonsillitis in a decompensated form. Because of him, the girl often had a sore throat and other ENT diseases.

“Christina was a bright, kind and very creative person. She studied music, sang well. That year she graduated from the Tambov College of Arts. She planned to move to Moscow, where she wanted to continue her studies and start working. She had big plans for the future. But first she wanted to improve her health. She doubted to the last whether she should do this in Tambov or whether it would be better to carry out this operation in Moscow. But we insisted that the operation was simple and that here, in Tambov, there would be those who could take care of her after the surgery. And she agreed. If we only knew then that everything would turn out this way, ”Olga Rechkalova, a close friend of the girl, tells NT.

Kristina’s operation was scheduled for July 12, it was performed under general anesthesia. However, instead of the usual 20-30 minutes, for some reason it lasted two hours.

“Kristina was brought to the ward with uncontrolled bleeding,” continues Olga Rechkalova. – Dr. Marina Bychkova operated on her. When Christina’s alarmed mother asked the doctor: “Did the operation go through with complications?”, she simply dryly answered “Yes.” And no more comments.

Kristina recovered safely from anesthesia on the same day. But, according to relatives, she lost a lot of blood. Doctors said that this is a normal situation. Therefore, neither the patient herself nor her relatives began to argue with them.

Meanwhile, the bleeding continued.

“By that time, Christina could no longer speak, so we communicated with her exclusively via the Internet. She wrote that she was being injected with hemostatic drugs, that she had a fever, and pain appeared in the area of ​​the solar plexus. The swelling of the neck, throat, and root of the tongue did not subside, preventing her from breathing and swallowing – she could not even drink water, she drank a spoonful, drop by drop, barely mastering a quarter of a glass, then a half, although she should have normally taken liquid even on the day of the operation. To numerous complaints that, due to edema, she could not swallow and, accordingly, eat, the doctors brushed aside and convinced her that she herself was not trying, and she only needed to make an effort to start eating. “Through force,” as they constantly told her,” Olga continues.

In the following days, Christina’s condition stabilized: it didn’t worsen, but it didn’t improve either. her temperature sometimes dropped to 37.5, then rose above 38. She still couldn’t really drink and eat, counting a couple of sips of unsweetened compote, liquid broth, or at least just water as happiness.

Referral for tests

“I don’t want to eat as much as I want to drink. I would get drunk, something cool, ”Kristina wrote to her friend in the messenger.

Relatives and friends tried to alleviate the girl’s suffering somehow. Christina’s mother, Irina Erkina, repeatedly turned not only to the attending doctor, but also to the head of the ENT department, Dmitry Trusov, with a request to pay attention to her daughter, who by that time was already very emaciated and dehydrated.

“You know, Chris is a fighter by nature. She had a strong, strong-willed character. She was not accustomed to complaining over trifles. But when it became completely unbearable, Christina asked that they at least put a dropper with glucose on her. But in response, she was told that everything was going according to plan, ”says the second friend of the deceased, Tatyana Hortova.

The terrible news came on July 17th. Christina, who, according to the doctors, seemed to be on the mend, had a clinical death, the girl fell into a coma. Although half an hour before that, she corresponded with loved ones, she was fully conscious.

As a result, it turned out that her carotid artery had suddenly burst. For three hours the doctors tried to stop the bleeding, and when they finally managed to do this, and the girl was stabilized, the second carotid artery burst “by itself” in the same way. Later, in a conversation with relatives, doctors reported that the arteries were affected during the operation.

“I rushed to the hospital to talk to the doctors, until the last I was sure that this was some kind of mistake. But instead, I heard from the head of resuscitation the advice to “forget the person as soon as possible, disengage from the situation and arrange your life.” In all my attempts to shed light on the cause of the fatal deterioration of Chris’s condition, the doctor smirked and claimed that it was not my concern. Called to the hospital as a confidant of Christina, I was never able to get a bit of information either about the cause of the deterioration, or about the current condition of my friend, or about the prognosis, ”says Olga Moskvicheva, another close friend of the deceased girl.

Kristina’s mother and her friends repeatedly insisted that Tambov doctors involve Moscow or St. Petersburg specialists in the problem. But those, according to relatives, said that it was impossible to show the patient via video link. And later they even admitted that “this already makes no sense.”

Tired of inaction on the part of doctors, the girl’s mother Irina Erkina and her friend Olga Rechkalova wrote a statement to the Investigative Committee of the Tambov Region, as well as to the Oktyabrsky Department of the Ministry of Internal Affairs.

As Olga Rechkalova told NT, investigators seized from the hospital documents related to Kristina Popova’s medical history. A check has been started.

However, already on July 20, despite the declared improvement in her health, Christina passed away. The verdict of the doctors – the body could not stand it.

At the moment, the ENT department of the third city hospital refuses to make any comments.

“We can’t comment. All questions to the management, ”the NT correspondent was told in a phone call.

The Investigative Committee of the Russian Federation has not yet provided any official comments.

It is known that the autopsy is scheduled for Monday.

As the girl’s mother, Irina Erkina, told NT, she intends to get an honest investigation into her daughter’s death.

“We want an independent expert to perform the autopsy. We will strive for this. We will not allow this case to be put on the brakes, ”said Christina’s mother.

Dr. Marina Bychkova graduated from the Ryazan State Medical University in 2004 with a degree in General Medicine. Since 2015, Marina Bychkova has been working as a freelance expert in otorhinolaryngology at the regional health department. In June of this year, according to the results of the All-Russian competition of doctors, Marina Bychkova was awarded the title of “The Best Otorhinolaryngologist of Russia”.