What are the key indicators that suggest you might need a tonsillectomy. How do recurrent tonsil infections impact your health. When should adults consider tonsil removal. What are the differences between tonsillectomies for children and adults.

Understanding Tonsils and Their Function

Tonsils are an integral part of the immune system, acting as the body’s first line of defense against inhaled or ingested pathogens. However, in some cases, these small glands located at the back of the throat can cause more problems than they solve. When tonsils become repeatedly infected or enlarged, they can significantly impact a person’s quality of life, leading to the consideration of a tonsillectomy.

What exactly are tonsils?

Tonsils are two oval-shaped pads of tissue located on either side of the back of the throat. They are part of the lymphatic system and play a crucial role in trapping harmful bacteria and viruses that enter through the mouth or nose. By doing so, they help prevent infections from spreading to other parts of the body.

Common Signs and Symptoms of Tonsil Problems

Recognizing the signs of tonsil issues is crucial for timely intervention. Dr. Amit Patel, M.D., outlines several key symptoms that warrant a visit to your primary care physician:

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

These symptoms often indicate tonsillitis, an inflammation of the tonsils that can be caused by viral or bacterial infections. While occasional tonsillitis is common, frequent occurrences may signal a more serious problem that requires medical attention.

How can you differentiate between a common sore throat and tonsillitis?

While a sore throat can be a symptom of many conditions, tonsillitis typically presents with more severe pain, often accompanied by swollen tonsils that may have white or yellow spots. The presence of fever and swollen lymph nodes in the neck are also more indicative of tonsillitis rather than a simple sore throat.

Criteria for Considering a Tonsillectomy

The decision to undergo a tonsillectomy is not taken lightly and is based on specific criteria related to the frequency of infections. Dr. Patel outlines the following guidelines:

1. Seven or more episodes of documented bacterial tonsillitis in a year
2. Five or more episodes per year of documented bacterial tonsillitis over two consecutive years
3. Three or more episodes per year of documented bacterial tonsillitis over three consecutive years

These criteria help medical professionals determine if the benefits of surgery outweigh the risks and potential complications. It’s important to note that the decision is not based solely on the number of infections but also on how much they affect a person’s daily life and overall health.

Are there any exceptions to these criteria?

While the frequency of infections is a primary consideration, doctors also take into account other factors. For instance, if enlarged tonsils are causing sleep apnea, difficulty swallowing, or unintended weight loss, these issues may prompt consideration of a tonsillectomy even if the infection criteria are not fully met.

Tonsillectomies in Adults vs. Children

While tonsillectomies are more commonly associated with children, adults can also benefit from this procedure in certain circumstances. The surgical process is essentially the same for both age groups, but there are some notable differences in recovery and outcomes.

How does recovery differ between adults and children?

Recovery time and discomfort levels can vary significantly between adults and children:

• Adults typically require about two weeks for full recovery
• Children often recover within one week
• Adults tend to experience more prolonged discomfort due to the larger area that needs to heal
• Children generally experience less severe pain and bounce back more quickly

These differences are attributed to the size of the tonsils and surrounding tissues, as well as the body’s healing capabilities at different ages. Despite these variations, the overall success rate of tonsillectomies remains high for both adults and children when performed for appropriate indications.

Post-Operative Care and Recovery

Proper post-operative care is crucial for a smooth recovery after a tonsillectomy. Regardless of age, patients are typically advised to:

• Use pain medication as prescribed, such as Advil or Tylenol, to manage discomfort
• Stay well-hydrated by consuming plenty of fluids
• Eat soft, easy-to-swallow foods like pudding or gelatin
• Avoid strenuous activities during the recovery period

These measures help minimize discomfort and promote healing. It’s important to follow your doctor’s specific instructions, as they may vary based on individual circumstances.

What are the potential complications of a tonsillectomy?

The most significant complication associated with tonsillectomy is post-operative bleeding. This risk is highest between 5-7 days after surgery when the scabs covering the surgical site begin to fall off. Studies indicate that about 5-15% of patients experience some degree of bleeding after a tonsillectomy. While most cases are minor and resolve on their own, severe bleeding can occur and may require immediate medical attention.

Debunking Common Misconceptions

There are several misconceptions surrounding tonsillectomies that can lead to unrealistic expectations or unnecessary concerns. One of the most prevalent myths is that having your tonsils removed means you’ll never experience a sore throat again.

Can you still get strep throat after a tonsillectomy?

Contrary to popular belief, it is still possible to get strep throat or other throat infections after a tonsillectomy. However, the procedure typically results in a significant reduction in the frequency and severity of throat infections. This improvement in overall throat health is one of the primary benefits of the surgery for those who meet the criteria for tonsil removal.

It’s important to understand that while tonsils play a role in the immune system, their removal does not significantly compromise overall immunity. The body has many other defense mechanisms to protect against infections.

Long-Term Benefits and Considerations

For individuals who meet the criteria for tonsillectomy, the long-term benefits can be substantial. These may include:

• Reduced frequency of throat infections
• Improved sleep quality, especially for those with sleep apnea caused by enlarged tonsils
• Better overall quality of life due to fewer sick days and less discomfort
• Potential improvements in breathing and swallowing for those with chronically enlarged tonsils

However, it’s crucial to weigh these benefits against the risks and recovery process associated with surgery. The decision to undergo a tonsillectomy should always be made in consultation with a qualified healthcare provider who can assess your individual situation.

How does the removal of tonsils impact the immune system in the long run?

While tonsils do play a role in the immune system, their removal does not significantly compromise overall immunity. The body has numerous other lymphoid tissues and mechanisms to maintain immune function. In fact, for those with chronic tonsil issues, removal can actually lead to improved overall health by reducing the burden of frequent infections.

When to Seek Medical Advice

If you or your child are experiencing frequent throat infections or any of the symptoms mentioned earlier, it’s important to consult with a healthcare professional. They can provide a thorough evaluation and determine whether a tonsillectomy might be beneficial.

Remember, the decision to undergo a tonsillectomy is based on a combination of factors, including the frequency and severity of infections, impact on quality of life, and potential complications. Your doctor will consider your unique medical history and circumstances before recommending this procedure.

What questions should you ask your doctor when considering a tonsillectomy?

When discussing the possibility of a tonsillectomy with your healthcare provider, consider asking the following questions:

• Are there any alternative treatments we should try first?
• What are the specific risks and benefits in my case?
• How long will the recovery process take, and what can I expect during this time?
• How will the surgery impact my daily life in the short and long term?
• What precautions should I take before and after the surgery?

These questions can help you gain a comprehensive understanding of the procedure and make an informed decision about your health care.

In conclusion, while tonsillectomies are performed less frequently today than in the past, they remain an important treatment option for those suffering from chronic tonsil issues. By understanding the signs, symptoms, and criteria for this procedure, you can better navigate your healthcare journey and make informed decisions about your throat health. Always consult with a qualified medical professional to determine the best course of action for your individual needs.

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.

Tonsillectomy FAQs: Signs your child needs their tonsils out

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Some adults may remember a tonsillectomy (the surgical removal of the tonsils) as a rite of passage in childhood. While a tonsillectomy is still one of the most common surgical procedures for children, they are performed less frequently than in the past.

Amy Coffey, M.D., Pediatric Otolaryngologist at Children’s Health℠ and Associate Professor at UT Southwestern, regularly talks to parents about if or when their child needs their tonsils removed.

Here, she answers parents’ frequently asked questions including when a tonsillectomy should be performed and what they – and their child – can expect before, during and after surgery.

When should a child have their tonsils removed?

The two most common signs a child needs their tonsils removed is when the child has recurrent strep throat infections or obstructive sleep-disordered breathing.

• Recurrent strep throat infections – If your child has had seven strep throat infections in one year; five infections a year for two years in a row; or three infections a year for three or more years, your pediatrician will likely refer you to an ENT surgeon for evaluation.
• Obstructive sleep-disordered breathing (oSDB) – Also known as obstructive sleep apnea, oSDB is more than loud snoring. It can cause a child to stop and start breathing several times during the night and lead to serious health issues, including weight gain, pulmonary hypertension, behavioral problems and trouble paying attention.

Less common reasons a child may need a tonsillectomy include:

• Peritonsillar abscess – A complication from an untreated strep infection that causes a pus-filled pocket to form near one tonsil. It is more likely to recur unless tonsils are removed.
• Dysphagia – Difficulty swallowing due to large tonsil size

Reasons your child doesn’t need tonsils taken out include bad breath and large or swollen tonsils.

“Large tonsils in a child by itself isn’t an indication that a tonsillectomy is necessary,” cautions Dr. Coffey. “Though it’s a very safe procedure, tonsil removal is still surgery. The benefits must outweigh the risks of the procedure. Size doesn’t necessarily impact your child’s health.”

At what age can a child have a tonsillectomy?

A child at any age can have a tonsillectomy if the indications are severe. However, surgeons generally wait until children are 3 years old to remove tonsils because the risk of dehydration and bleeding is greater among small children.

Is a tonsillectomy safe?

A tonsillectomy is generally considered to be a safe procedure. As with any surgical procedure, there are risks associated. The most common risks include bleeding and dehydration.

How much bleeding is normal after a tonsillectomy?

Bleeding is most common within 24 hours after the surgery and then again anywhere from 5-14 days when scabs come off after surgery. Most of the time, children and parents aren’t even aware there is bleeding. It can irritate the throat and stomach and cause children to vomit, which is when parents usually become aware there is bleeding.

“Bleeding can be scary, but it doesn’t last long,” explains Dr. Coffey. “It does need medical attention to ensure there are no complications from the surgery, though. If your child has severe bleeding – bleeding that doesn’t stop – call 911. Otherwise, call your child’s surgeon to determine if your child needs to be seen.”

How can I encourage my child to drink after a tonsillectomy?

Children may be hesitant to drink after surgery because of throat pain. It’s important for them to drink regularly so they stay hydrated, which can help the healing process.

Dr. Coffey shares several do’s and don’ts with parents to help encourage fluids after surgery:

• Do set a timer once or twice an hour the first few days after surgery so parents and kids remember to take a few sips
• Do offer popsicles
• Do offer water or 100% juice
• Do give small amounts of water by syringe like medication if refusing to drink
• Don’t offer thick drinks like milkshakes unless using a spoon
• Don’t use straws or sippy cups as suction can irritate the throat

How can I help relieve my child’s pain after a tonsillectomy?

A sore throat and pain are the most common side effects of a tonsillectomy. Regular fluids can help ease a sore throat and pain, in addition to keeping kids hydrated after surgery.

Over-the-counter pain medicine is also effective pain relief after tonsils are removed. You can alternate children’s acetaminophen (such as Tylenol) and a non-steroid anti-inflammatory (such as ibuprofen) to help control pain. Be sure to follow your surgeon or nurse’s dosing instructions, including the amount and frequency.

“I often recommend parents wake children up the first night or two after surgery to stay on top of pain relief,” offers Dr. Coffey.

How long does recovery take after a tonsillectomy?

Generally, most children are back to normal about 10 days after a tonsillectomy.

“The first two or three days are very intense. That’s when your child needs the most attention,” says Dr. Coffey. “Keep them drinking fluids and limit activities those first few days.”

Your child should avoid contact sports or heavy physical activity for two weeks after surgery because of the risk of bleeding.

Children can return to school once the throat is completely healed, which can be anywhere from 10 days to two weeks. Your surgeon can help you determine the schedule that’s right for your child and family.

Learn more

The ear, nose and throat team at Children’s Health includes fellowship-trained, board-certified physicians, advanced practice providers, nurses and support staff who have special training to diagnose and treat children with ENT issues. Learn more about our ENT program, services and support we offer children and families.

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indications, contraindications, possible complications and ways to deal with them in the MEDSI Clinic

Tonsillectomy is a surgical intervention, the essence of which is removal of the palatine tonsils . Today, the operation is carried out using various methods and tools. Technologies are being actively introduced to reduce tissue trauma, the duration of the recovery period and discomfort in patients. An intervention is carried out in chronic tonsillitis. The decision on tonsillectomy is made only by a doctor and in the presence of individual indications. As a rule, surgery is prescribed only if conservative therapy does not lead to recovery of the patient and a significant improvement in his condition.

Important! Intervention is carried out only in a hospital . Before hospitalization, the patient undergoes a comprehensive examination, to which he is directed by an ENT doctor.

Indications for intervention

Main indications for tonsillectomy:

• Tonsillitis with many relapses. Surgery is indicated if the patient suffers from 5-7 exacerbations within 1-2 years
• Sleep apnea syndrome
• Purulent complications of pathology
• Decompensated form of the disease
• Swallowing disorders
• Chronic tonsillitis, which increases the risk of a number of comorbidities (kidney disease, rheumatism, etc. )
• Daytime respiratory disorders

With purulent complications of the pathological condition, the intervention is carried out after a course of antibiotics. Medicines are taken in dosages recommended by the doctor. This reduces the risk of complications after tonsillectomy. In other cases, the operation is performed only during remission.

Important! If a few years ago one of the contraindications was the age of the patient, today the intervention is carried out for children from 2 years old, as well as for the elderly.

Contraindications

All contraindications to intervention are divided into:

• Absolute. If such contraindications are found, tonsillectomy is not performed
• Relative. If they are present, the intervention should be postponed for a certain time (usually until the patient has fully recovered)

Absolute contraindications include:

• Serious blood disorders
• Diabetes mellitus
• Pulmonary tuberculosis
• Abnormalities (aneurysms, for example) of pharyngeal vessels
• Serious diseases of the nervous system

Relative contraindications include:

• Acute infectious and inflammatory diseases
• Caries and other pathologies of the oral cavity, provoking the reproduction of dangerous microorganisms
• Acute dermatitis and other skin pathologies

Your doctor will tell you about all contraindications. He will decide on the intervention.

Important! The decision on the expediency of tonsillectomy is made by the therapist (pediatrician) together with the ENT. The anamnesis, the effectiveness of drug therapy are preliminarily assessed, the patient undergoes a complete examination, including radiography, blood and urine tests, and other studies that determine contraindications to intervention. Indications for tonsillectomy are also carefully studied.

Intervention options

Tonsillectomy can be performed using the following techniques:

• Tissue excision with special instrument . Such an intervention is carried out quite often. The advantages of the technique include the ability to completely remove the tonsils. The surgeon can quickly open lesions with purulent contents
• Electrocoagulation . With such an intervention, the tonsils are excised by exposing them to an electric current with pre-selected indicators. The advantages of electrocoagulation when removing the tonsils include minimal blood loss and a high speed of the procedure. Important! Most of the complications after this intervention are associated with heating of healthy tissues
• Ultrasound tissue excision . The intervention, which is carried out using a special scalpel, is characterized by a small blood loss and minimal damage to surrounding tissues
• Radiofrequency ablation . With this intervention, performed under local anesthesia, the tonsils are removed by exposing them to radio waves. The advantages of the technique include a quick recovery. Important! Typically, the technique is used to reduce the volume, and not remove the tonsils. This is due to the fact that it is simply impossible to eliminate large formations with radio frequencies
• Thermal welding method . This intervention is carried out using an infrared laser. The advantages of the method include the absence of pain, the possibility of performing under local anesthesia, minimal blood loss and a reduction in the risk of serious tissue edema
• Carbon laser tissue excision . Vaporization is a method characterized by simplicity, rapid intervention and a short rehabilitation period
• Coblation . This technique is based on the use of radio frequency energy. The dissection of tissues is performed by separating the molecular bonds between them. All intervention risks are reduced due to the absence of thermal effects. The advantages of the technique include a minimum of complications and quick rehabilitation due to minimal tissue trauma

Recovery after intervention

As early as 2-3 days after the intervention, the niches of the tonsils are covered with plaque. The patient may complain of increased discomfort when swallowing. The temperature may rise (not significant). Raids disappear for 4-5 days. Complete cleansing of the intervention area is noted by the end of the second week of the rehabilitation period. Finally, the wounds heal after about 2.5 weeks.

After the intervention, which is performed using a surgical instrument (scalpel), nothing should be swallowed during the day. The next day, you are allowed to drink and eat soft food. The patient should adhere to a sparing diet for 10-20 days.

Throughout the rehabilitation period, it is prohibited :

• Exercise, bend over and lift weights. Any exercise can lead to bleeding
• Consume alcoholic beverages which can also cause bleeding
• Take a hot bath
• Eat hot meals, salty, spicy foods, carbonated drinks. You should also refuse chips, cookies, gingerbread, nuts, crackers, which can damage the wound surface
• Visit the sauna and bath

After tonsillectomy, the patient is prescribed a special diet.

It includes the use of:

• Baby puree
• Pureed porridge
• Soft dairy products

3-5 days after the intervention, you can start eating soft meatballs and meatballs, cereals, pasta.

During rehabilitation, it is forbidden to drink juices with citrus fruits. This is due to the fact that fruit acids have a pronounced irritant effect.

After tonsillectomy using modern techniques (laser and others), rehabilitation is faster and easier for the patient. Wounds heal in just a few days. The patient does not have to follow a strict diet or experience other restrictions. However, it is important to follow all doctor’s recommendations. Only he can give an objective assessment of the patient’s condition and eliminate the risks of complications. The specialist will prescribe the time of appointments, issue prescriptions for the use of medications.

Complications

Professionally performed intervention practically does not cause complications in the recovery period.

However, there may be:

• Minor bleeding
• Pain
• Discomfort when swallowing
• Cicatricial changes in the sky

Usually, all discomfort disappears as the wound heals.

If the patient continues to complain of discomfort, examination and diagnosis are mandatory. Each complication is considered by experts individually. An integrated approach is very important, which allows you to determine why problems arose, how to eliminate them, whether in this case hospitalization of the patient is required.

Particular attention is paid to complications in children. This is due to the fact that often they cannot independently determine their condition and the severity of symptoms. Parents without medical education are also unable to decide on the need for therapy for certain complications.

Emergency care is usually required for patients only with severe bleeding. In some cases, blood transfusion is performed, drugs are administered that stop bleeding, reduce the risk of wound infection, etc.

The course of the rehabilitation period can be complicated by infections and inflammatory processes. Prophylactic (before intervention) use of antibiotics helps to reduce the risk of their occurrence. Complications provoked by infections and inflammations usually occur with improper preparation for tonsillectomy in patients whose body is weakened by concomitant pathologies, in violation of the regimen, non-compliance with the recommendations given by the doctor as part of the rehabilitation, when the patient is infected at the recovery stage with influenza or SARS.

Advantages of intervention in MEDSI

• Use of a wide range of techniques for tonsillectomy . Selection in favor of a specific one is carried out by the therapist and the otorhinolaryngologist together with the patient. Preliminary assessment of the results of conservative therapy and medical history
• Use for intervention modern equipment, consumables and painkillers . This reduces the risk of pain and severe discomfort in the patient, reduces the duration of the recovery period and the likelihood of complications
• Intervention only by experienced specialists highly qualified
• Comfortable environment in the clinic, providing a favorable emotional background for the patient. You do not have to be afraid of the operation, worry about how it will go. Specialists will answer all questions in advance
• Opportunities for preliminary consultation, examination and direct tonsillectomy at a convenient time

To make an appointment with a doctor at MEDSI, just call +7 (495) 7-800-500.

Do not delay treatment, see a doctor now:

• Otorhinolaryngologist appointment
• ENT surgery
• ENT endoscopy

Tonsillectomy (removal of the tonsils) – prices in Moscow

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