Tonsillectomy - Procedure, Recovery & Who Needs It?

What is a Tonsillectomy?

A tonsillectomy is a surgical procedure that removes the tonsils. The tonsils are a pair of lymph node-like small masses located at the back of the throat. They are part of the body's immune system and help fight infection. However, they can also become infected, which can lead to tonsillitis.¹

Tonsillitis is a common childhood illness, but it can occur at any age. Symptoms include enlarged, swollen tonsils, painful sore throats, fevers, and difficulty swallowing. 

A doctor may recommend a tonsillectomy if someone has chronic tonsillitis that does not respond to treatment.

When Do You Need a Tonsillectomy?

Doctors used to perform tonsillectomies routinely to treat chronic tonsillitis. The frequency of tonsillectomies has declined more recently because experts are concerned they cause more problems than they solve.

In a large study of more than 1 million people, researchers looked at the long-term effects of having a tonsillectomy, adenoidectomy, or both as a child.

An adenoidectomy is a surgical procedure that removes the adenoids, which are also patches of tissue in the back of the throat that protect the body from germs. 

The study found that people who had these surgeries were significantly more likely to experience upper respiratory tract infections later in life. The surgeries also didn’t prevent people from getting colds, sore throats, or throat infections.²

Therefore, the decision to have a tonsillectomy is based on a combination of factors, including:

• The severity and frequency of tonsillitis 
• How long each episode of tonsillitis lasts
• The presence of other medical conditions
• How well the person tolerates the symptoms of tonsillitis

People may also have a tonsillectomy if they have trouble breathing. The procedure can help with mouth breathing, snoring, and obstructive sleep apnea.³

Tonsillectomy Procedure 

Before the tonsillectomy, you will consult a doctor who specializes in adult or pediatric otolaryngology. 

They may perform a physical exam, take a medical history, and discuss the risks and benefits of the procedure. You'll also find out what to expect during recovery and have the opportunity to ask any questions. 

Preparing for Surgery

A doctor or nurse will provide clear instructions on preparing for surgery. Follow their directions carefully to reduce the likelihood of complications.

Preparation for surgery usually includes:

• Not eating after midnight before the surgery to prevent vomiting during surgery 
• Reducing or stopping certain medications a few days before the surgery
• Arranging for transport home, so you don't have to drive
• Planning for around 2 weeks of recovery time
• Signing a consent form confirming that you understand the risks of surgery

For most people, a tonsillectomy is an outpatient procedure. Therefore, you probably won't need to prepare to stay overnight in the hospital or surgery center.

Procedure Steps

The tonsillectomy procedure is as follows:⁴

1. An anesthesiologist administers a general anesthetic. These medications ensure you stay asleep and cannot feel pain during the surgery.
2. The surgeon inserts an instrument into your mouth to keep it open so they can reach the tonsils.
3. They then cut away the tonsils with a scalpel, laser, or curette. Any bleeding is controlled by cauterizing the incision. The wound does not require stitches.
4. Following the procedure, a nurse takes you to the recovery room and closely monitors your vital signs. This involves taking your pulse, blood pressure, and breathing rate as you recover from the anesthetic.

Once you're completely awake, and a doctor confirms you can breathe and swallow properly, you'll be discharged with a detailed care plan. If you have difficulty breathing or have any other issues, you may need to stay in the hospital overnight for observation. 

How Long Does a Tonsillectomy Take?

A tonsillectomy is a quick and straightforward procedure that typically takes less than 30 minutes. 

Expect to spend at least half a day in the hospital, as both admission and recovery require several hours.

Tonsillectomy Recovery & Aftercare

Recovery from removal of the tonsils is different for everyone. Most children feel fine after a few days, while adults may take a couple of weeks to recover completely. This is because the tonsils are larger, and therefore, surgical removal is more difficult.

The following tips will help wounds heal naturally and reduce risks of complications:

• Rest as much as possible for the first few days. After that, avoid physical activity for at least a week.
• Eat soft, bland foods and gradually return to a regular diet as pain improves. 
• Take over-the-counter (OTC) pain medications, such as ibuprofen, to reduce discomfort. 
• Gargle with warm salt water several times a day to reduce swelling and pain.
• Use a humidifier to soothe throat pain and relieve congestion.
• Brush your teeth gently to avoid irritating your healing throat.
• Stay hydrated by drinking enough liquids. Avoid alcohol and caffeinated beverages.
• Stock your freezer with ice cream and popsicles that can soothe a painful throat.

Recovery Timeline

Although everyone recovers at a different rate, here is a generalized recovery timeline:

• Day 1 — on surgery day, you'll receive general anesthesia, which can take several hours to recover from. Although you’ll receive pain medications, you'll likely have a sore throat when you wake up. You may also have a mild fever.
• Days 2 to 3 — the pain is usually worse on these days. You can take over-the-counter pain medication and use ice chips or popsicles to help with the pain. Drink plenty of fluids.
• Days 4 to 5 — the pain should start to improve. You can gradually return to your normal diet.
• Days 6 to 7 — most people feel back to their normal selves by the first week. However, some may still have a sore throat.
• 2 weeks — although some people feel fine after a week, others may take up to 2 weeks to recover completely and be pain free.⁵

What to Eat After a Tonsillectomy 

Your throat will be sore following a tonsillectomy. So, choosing soft foods and cold drinks and avoiding spicy foods may be best during recovery. You can gradually add solid foods back into your diet as your pain improves.

Good foods to eat after surgery include:

• Clear soup or broth
• Mashed potatoes
• Applesauce
• Jell-O
• Bananas
• Ice cream
• Popsicles

Maintain adequate hydration following surgery, particularly during the first couple of days. Hydration helps keep skin moisturized, which helps wounds heal and reduces pain. 

Opting for chilled drinks like apple juice or ice water or warm drinks may help with pain and have a soothing effect. 

However, avoid hot liquids, as they can worsen the pain. Because their heat causes blood vessels to widen, hot drinks can also cause bleeding. 

What are the Risks of Tonsil Removal?

As with any surgery, tonsillectomy carries certain risks, including:

• Reactions to anesthetics — you may feel sick, dizzy, or vomit following general anesthesia, but these effects usually resolve quickly. Serious long-term health issues are rare, but general anesthesia can be risky.
• Swelling — in the first few hours following the operation, the tongue and soft palate can swell, causing breathing difficulties. This should resolve in the first 24 hours.
• Bleeding during surgery — in some cases, people bleed heavily during surgery and must stay in the hospital for longer.
• Bleeding during healing — bleeding can also happen during the healing process, particularly if the scab from the wound becomes dislodged.
• Infection — surgery can lead to infections that require antibiotic medications and other treatment.

How Much Does a Tonsillectomy Cost? 

The cost of a tonsillectomy will depend on several factors, including:

• Insurance coverage
• Facility location
• The surgeon
• Anesthesia
• Complications
• Time spent in hospital
• If the procedure was a combined tonsillectomy and adenoidectomy

Tonsillectomies are typically straightforward and quick procedures with a relatively low cost. They cost around $2,500 but can range from $1,000 to $4,500.⁶

Summary

A tonsillectomy is a surgical procedure that removes the tonsils. It's usually performed as an outpatient surgery and takes around 30 minutes. Doctors may recommend it if someone has recurrent tonsillitis or breathing problems.

Recovery from the operation can take up to 2 weeks, during which you may experience pain and swelling. Eating soft foods and staying hydrated will help with recovery.

Tonsillectomies carry certain risks, but they are usually minor. The cost of the procedure will depend on insurance coverage and other factors.