Adult Tonsillectomy

Tonsils are clumps of lymph tissue forming a ring around the back of the mouth. The two clumps we can see on the sides are what people usually call the tonsils. At the back of the tongue, beyond where you can see, are the lingual tonsils. Finally, hidden by the palate, directly behind the nose are the lumps we call adenoids. The lymphatic system is part of the immune system. The clumps of lymph tissue in the back of the mouth are a small fraction of the body's supply. They can be safely removed without any known damage to the immune system.
While lymph tissue swells in children during the first ten years of their lives, it slowly shrinks in size with age. Only about 10% of adults have significantly large clumps of adenoid tissue. An exception to this trend is the lymph tissue swelling that can persist after a bout of mononucleosis.


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There is a misconception that adults do not get tonsillectomies. There are several good reasons to remove one’s tonsils as an adult. The procedure is still very useful, when one considers that there are no effective medicines or gargles that will relieve these conditions.

Reasons to perform a tonsillectomy

frequent bouts of acute tonsillitis. The number requiring tonsillectomy varies with the severity of the episodes. One case, even severe, is generally not enough for most surgeons to decide tonsillectomy is necessary.
chronic tonsillitis (persistent, moderate-to-severe throat pain) They may or may not have bad-tasting white material popping out them (tonsil calculi)
a peritonsillar abscess- a dramatic and painful infection of the tissues surrounding a tonsil (estimated 15-20% chance of happening again without a tonsillectomy)
sleep apnea (stopping or obstructing breathing at night). Less likely a major contributing factor in adult sleep apnea with the exception of young adults after a bout of mononucleosis. Enlarged tonsils may also make swallowing, eating and talking difficult.
Asymmetric tonsils or enlargement of a single tonsil. Tumors of the tonsils (lymphoma) are rare, but when tonsils are not the same size it may be recommended to remove one of both of them to check the tissue.

Procedure

There are many different techniques for removing tonsils. You can discuss this with your doctor. A popular new technique is coblation because it reduces the risk of bleeding during the operation and creates a less painful wound. Almost all adult tonsillectomies are performed in an outpatient surgery center and patients return home in the car and under the care of a close friend or family member.

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Risks

Pain- The throat will be sore until the mucous membrane grows over the exposed muscles. It is particulary painful when swallowing. Sometimes the pain feels as if it is coming from the ears. A variety of medicines are given to minimize this discomfort. Eighty per cent of adult patients say that the pain after surgery isn't worse than what they experienced during a tonsil infection.
Bleeding – This can occur immediately after the surgery, but is more common during the second week of recovery when the new mucous membrane with its new blood vessels are growing over the wound. Most commonly a small amount of bleeding will occur but stop on its own.
Anesthesia – less of a risk in adults than children
Dehydration – Fever and malaise can occur if patients do not drink enough after surgery.
Instrument injuries- The surgical tools put some stress on the front teeth and can occasionally injure a tooth or lip. The instrument that removes the tonsils can also cause mild burns to the tongue and uvula.

"It was my only surgery and as pleasant as a surgery could be. I felt good going into it with confidence in those taking care of me and I felt even better coming out knowing everything went well… I was able to talk and eat the day I had the procedure done. I was sore but the meds helped fine. Went back to work after two weeks and was fine bedsides a little soreness when I yawned." - Katherine O’Conner