ENT health

When Should Tonsils Be Removed in Adults?

Written by Dr. Mohammed Osama Aboborda and medically reviewed by iCliniq medical review team.

 
Image: When Should Tonsils Be Removed in Adults?

Tonsillectomy is one of the most popular operations in the otorhinolaryngology field. The most frequently asked questions about tonsillectomy are:

  • When is tonsillectomy indicated?
  • Does tonsillectomy affect our immunity?
  • What is the best method for tonsillectomy?
  • What are tonsillectomy complications?

When Is Tonsillectomy Indicated?

Tonsillectomy is indicated in certain cases of chronic tonsillitis. Chronic tonsillitis is characterized by inequality in size of both tonsils, congested anterior pillars which cover tonsils anteriorly, the collection of pus inside the tonsillar crypts even in the absence of acute inflammation, recurrent attacks of acute follicular tonsillitis and palpable neck lymph nodes.

Peritonsillar abscess is an important indication for tonsillectomy. Peritonsillar abscess is an acute infection presented by the collection of pus in the space between the tonsil capsule and anterior pillar, fever, dysphagia, and severe throbbing pharyngeal pain. Peritonsillar abscess is usually unilateral. Just one attack of peritonsillar abscess is an indication for tonsillectomy.

Impacted foreign body inside the tonsils is another indication for tonsillectomy. Many different foreign bodies may be impacted into the tonsils but the most common are fish and bird bones. These bones are impacted in the tonsils during eating. If the foreign body cannot be extracted through the mouth, tonsillectomy would be indicated.

Does Tonsillectomy Affect Our Immunity?

Tonsils are lymphoid tissues. Tonsils play an important role in human immunity but its removal does not harm immunity because the body is full of other lymphoid tissues. The important point is the presence of an indication for tonsillectomy.

What Is the Best Method for Tonsillectomy?

Now, there are a lot of methods for tonsillectomy such as diathermy, radiofrequency, laser surgery, cryosurgery and the cold surgery. Cold surgery means the use of surgical instruments away from any source of heat as diathermy and laser. The best method is the method that your surgeon prefers. The aim is to remove tonsils completely without primary bleeding.

What Are Tonsillectomy Complications?

Some of the complications of tonsillectomy are primary hemorrhage, secondary hemorrhage, and residual tonsil tissue.

Primary hemorrhage is the hemorrhage that happens within the first twenty-four hours after the operation. Primary hemorrhage can be because of slipped ligature, detached thrombus which occludes a blood vessel and elevated blood pressure after coming back from anesthesia effect. Primary hemorrhage is an emergency. The patient must go through surgical closure of the bleeding blood vessel. Sometimes, external carotid ligation is mandatory if direct closure of the bleeding vessel has failed.

Secondary hemorrhage is the hemorrhage that happens after the first twenty-four hours have passed. It is mostly secondary to the bacterial infection at the site of surgery. So, antibiotics are important after tonsillectomy to prevent bacterial infection. Dealing with secondary hemorrhage is different from that of primary hemorrhage. In case of secondary hemorrhage, the patient's throat must be irrigated with hydrogen peroxide under general anesthesia to remove all the infected tissues. In many cases, just previous irrigation is enough to stop the bleeding but in other cases, external carotid ligation is needed to stop bleeding.

Residual tonsil tissue is a common complication. Residual tonsil tissue can be inflamed again and again. Residual tonsil tissue can increase in size because of repeated inflammation. This hypertrophied residual tonsil tissue may need another surgery to be removed.

For more information consult a tonsillitis specialist online --> https://www.icliniq.com/ask-a-doctor-online/ENT-Otolaryngologist/tonsillitis

Last reviewed at: 07.Sep.2018

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