Learn more about the removal of tonsils and adenoids, and what to expect following a adenotonsillectomy.

What are the tonsils and adenoids?

Most people have heard of the tonsils, and some have heard of the adenoids, but not everyone knows where they are. The tonsils lie at the back of the throat and the adenoids lie at the back on the nose. The role of the tonsils and adenoids is to help our body’s immune system. They play a minor role in comparison to the body’s overall defences, which is why they can be removed.

Why do ENT Specialists remove the tonsil and adenoids?

Depending on the health problem, it may be recommended that either the tonsils or adenoids be removed alone, but often they are removed at the same time. The most common reason for removing the tonsils and adenoids is when they are causing blockage to breathing at night- this is a condition known as “Sleep Disordered Breathing” or SDB for short. This condition can be so bad that the blockage prevents children from breathing all-together. This is known as “Obstructive Sleep Apnoea” or OSA. There is more about this written below.

The other reasons for recommending removal of the tonsils is when there have been several episodes of tonsillitis. It is the frequency and severity of the infections that acts as a guide to the benefit of tonsillectomy. Other types of infections that tonsillectomy may be indicated for include an abscess near the tonsil and a low grade chronic sore throat. Rare indications for tonsillectomy include Psoriasis (and other certain skin diseases), PANDAS, and prion disease.

The adenoids lie at the back of the nose and may cause nasal blockage. This may result in a runny nose, snoring, mouth breathing and altered speech. The adenoids also lie near the tubes that go from the back of the nose to the ears. It is because of this close relationship that the adenoids may be removed to help reduce middle ear infections.

What are the risks of removing the tonsils and adenoids?

The risks of any operation is something you should be aware of. There are many potential problems that may occur, but fortunately these are mostly rare. The one guaranteed problem afterwards is pain. This may last for up to 2 weeks but is usually about a week in children. The other main risk, especially with tonsillectomy, is bleeding after the operation. These risks, and others are explained in detail to you at your visit to an ENT Specialist.

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Sleep disordered breathing (SDB) and obstructive sleep apnoea (OSA)

We all know how important it is to breathe but did you know that snoring is a noise that is made when there is a blockage to airflow whilst we are asleep? ENT Surgeons have long been aware that sleep apnoea can have serious health effects including heart problems, impaired growth, altered facial growth, and altered chest wall development. It is very scary for parents to witness their child stop breathing at night.

We now know that breathing disturbances at night resulting in snoring may have an effect on children during the day as well as at night. This may be evident by day time tiredness, poor concentration, poor school performance, behavioural problems (including Attention Deficit Disorder or ADD or ADHD) and bed wetting. If you have concerns about your child and their snoring, you should firstly talk to your GP.

The tonsils are a general reference to the round swellings of tissue (known as lymphoid aggregates) in the mouth. There are infact additional tonsils that run along the back of the tongue (knows as “lingual tonsils”). As opposed to the normal tonsils, lingual tonsils do not usually cause problems and do not normally need to be removed. Fortunately, the tonsils can be removed without any significant impact on the body’s stronger general immune system.

Tonsillectomy may involve any combination of the following:

  • Removal with surgical instruments and sutures to stop bleeding
  •  Diathermy, which is also known as electrocautery.
  • Coblation, which is a new technology.
  • Laser, which is not as popular these days due to the greater amount of pain caused.

The tonsils may be removed in isolation or in combination with other procedures such as adenoid removal and grommets. The main reason for tonsils being removed is because they are large and causing obstruction to breathing and/or eating, or they are getting infected too often, too long, or quite badly.

The main problem after tonsil removal is pain, and the most concerning risk is bleeding. This is the one procedure where paying for experience is really worth it. Learn more about the common post operative complaints following tonsillectomy and adenoidectomy


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This article is for informational purposes only and should not be taken as medical advice. If in doubt, HealthEngine recommends consulting with a registered health practitioner.

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