Introducing: Ask a Doctor
At UTHSC ENT, we understand that patients need clear, helpful answers to their questions. We also know that a flood of new information can be overwhelming.
That’s why our department’s introducing Ask a Doctor: an ongoing series of posts that tackle Frequently Asked Questions about common issues. We hope these articles give you a better understanding of your situation and an easy path to treatment.
Today, let’s talk about adult tonsillectomy!
Prepared by: Emily Baker, UTHSC Medical Student
Reviewed by: Dr. M. Boyd Gillespie
First, what are the tonsils?
Tonsils are collections of soft tissue located at the back of the throat that contain similar tissue to our lymph nodes. They normally trap germs and foreign particles before they are inhaled to prevent harmful substances from reaching the lungs.
Why might adults need their tonsils removed?
Studies have shown that when indicated, adult tonsillectomy can greatly improve quality of life. In some individuals, tonsils can lead to a whole host of problems, so when they are removed, people may experience less illness, fewer missed days of work, improved sleep, and decreased risk of certain diseases.
Reasons for adult tonsillectomy include:
Some people have tonsils that are prone to frequent inflammation (tonsilitis) and infection.
2) Airway Obstruction
The tonsils usually decrease in size as we age. In some people, they do not regress, and can obstruct the upper airway. This is particularly problematic when it occurs during sleep, causing Obstructive Sleep Apnea (OSA). OSA occurs when you temporarily stop breathing throughout the night and can have many negative implications for your health. The most apparent problem is excessive daytime sleepiness, but left untreated, OSA can increase your risk for hypertension, heart disease, and stroke.
3) Halitosis (i.e. bad breath)
Small debris from the food we eat can get trapped in the holes of the tonsils and cause chronic bad breath. This debris is known as tonsil stones (tonsiliths). The tonsil stones can cause pain, bad taste, and foul breath.
Although rare, some cancers can originate in the tonsils. In fact, tonsil cancer is increasing due to increased exposure to human papillomavirus (HPV) infection. If your doctor is concerned about this, they will remove your tonsils.
Adult tonsillectomy: what to expect
Tonsillectomies are usually performed as an outpatient procedure, meaning you will go home the same day of your surgery. You will need someone to drive you to and from your surgery. Your doctor will tell you when you need to stop eating and drinking prior to surgery. It is essential that you follow these instructions in order to prevent complications from the anesthesia.
You will be completely asleep for the procedure. Afterwards, you will spend some time in the post-anesthesia care unit (PACU), where your vitals will be monitored as you wake up from anesthesia. After several hours, you will be allowed to go home.
Your doctor will prescribe medications for pain, and they may prescribe other medications to help in your recovery, such as a steroid, antibiotic, or mouthwash. Make sure to take all of your medications as prescribed. You will also need to avoid aspirin and ibuprofen, as these can increase your risk of bleeding.
Your doctor will give you specific post-operative instructions, but generally, expect to participate in minimal activity for approximately 48 hours, and full recovery usually takes 10-14 days. You should not drive or operate machinery until you are no longer taking pain medications. Make sure to drink plenty of fluids throughout your recovery to prevent dehydration and speed up healing.
Several days after your adult tonsillectomy, you will notice the back of your throat turn white. This is due to the formation of scabs over the surgery site and is completely normal.
You should experience minimal bleeding after a tonsillectomy. Severe bleeding is most likely to occur within the first 10 days after surgery. If you notice blood in your mouth, sit upright immediately. Gargling ice water or water mixed half and half with hydrogen peroxide can reduce the bleeding. If the bleeding does not resolve quickly, call your doctor or go to the emergency room. If the bleeding is severe, it may require emergency surgery.
Nausea and Vomiting
This can occur as a side effect of the anesthesia or pain medications. Call your doctor if you are unable to swallow fluids.
A certain degree of pain is expected after surgery. If your pain medications are not helping and you cannot maintain adequate fluid intake, call your doctor.