Minas N. Artopoulos M.D.
Otorhinolaryngologist, Head & Neck Surgeon
Director of Neck-Thyroid Division at the MITERA Otorhinolaryngology Head & Neck Surgery Department

Tonsillectomy (ton-sih-LEK-tuh-me) is the surgical removal of the tonsils, two oval-shaped pads of tissue at the back of the throat — one tonsil on each side.

A tonsillectomy was once a common procedure to treat infection and inflammation of the tonsils (tonsillitis). Today, a tonsillectomy is usually performed for sleep-disordered breathing but may still be a treatment when tonsillitis occurs frequently or doesn’t respond to other treatments.

A tonsillectomy may also be necessary to treat breathing and other problems related to enlarged tonsils and to treat rare diseases of the tonsils.

Recovery time for a tonsillectomy is usually at least 10 days to two weeks.

A tonsillectomy is used to treat:

Recurring, chronic or severe tonsillitis
Complications of enlarged tonsils
Other rare diseases of the tonsils

Tonsillitis

Tonsils produce certain types of disease-fighting white blood cells. Therefore, the tonsils are believed to act as the immune system’s first line of defense against bacteria and viruses that enter your mouth.

This function may make them particularly vulnerable to infection and inflammation. The problem is more common in children because the immune system function of tonsils is most active before puberty. Also, unlike an adult’s immune system, a child’s system has had less exposure to bacteria and viruses and has yet to develop immunities to them.

A tonsillectomy may be recommended to prevent frequent, recurring episodes of tonsillitis. Frequent is generally defined as:

More than seven episodes a year
More than five episodes a year in each of the preceding two years
More than three episodes a year in each of the preceding three years

The procedure may also be recommended if:

A bacterial infection causing tonsillitis doesn’t improve with antibiotic treatment
An infection that results in a collection of pus behind a tonsil (tonsillar abscess) doesn’t improve with drug treatment or a drainage procedure

Complications of enlarged tonsils

Tonsils may become enlarged after frequent or persistent infections, or they may be naturally large. A tonsillectomy may be used to treat the following problems caused or complicated by enlarged tonsils:

Difficulty breathing
Disrupted breathing during sleep
Difficulty swallowing

Other diseases of the tonsils

A tonsillectomy may also be used to treat other rare diseases or conditions of the tonsils, such as:

Cancerous tissue in one or both tonsils
Recurrent bleeding from blood vessels near the surface of the tonsils

Tonsillectomy, like other surgeries, has certain risks:

Reactions to anesthetics.

Medication to make you sleep during surgery often causes minor, short-term problems, such as headache, nausea, vomiting or muscle soreness. Serious, long-term problems are rare, though general anesthesia is not without the risk of death.

Swelling.

Swelling of the tongue and soft roof of the mouth (soft palate) can cause breathing problems, particularly during the first few hours after the procedure.
Bleeding during surgery.

In rare cases, severe bleeding occurs during surgery and requires additional treatment and a longer hospital stay.
Bleeding during healing. Bleeding can occur during the healing process, particularly if the scab from the wound is dislodged too soon. Emergency surgery to stop the bleeding is riskier than scheduled surgeries that allow for appropriate pre-surgical safeguards, such as fasting.
Infection.

Rarely, surgery can lead to an infection that requires further treatment.

How you prepare

You’ll receive instructions from the hospital on how to prepare yourself or your child for a tonsillectomy.

Information you’ll likely be asked to provide includes:

All medications, including over-the-counter drugs and dietary supplements, taken regularly
Personal or family history of adverse reactions to anesthetics
Personal or family history of bleeding disorders
Known allergy or other negative reactions to medications, such as antibiotics.