What is a tonsillectomy?

A tonsillectomy is a surgical procedure in which the tonsils are removed from the back of the throat. The tonsils are a pair of small, oval-shaped masses of tissue located on each side of the throat, at the back of the mouth. Tonsillectomies are typically performed to treat various medical conditions related to the tonsils.

Common reasons for a tonsillectomy include:

Recurrent Tonsillitis: When a person experiences frequent and severe bacterial or viral infections of the tonsils, which can lead to symptoms such as sore throat, fever, and difficulty swallowing.

Chronic Enlargement: Enlarged tonsils can lead to breathing difficulties, especially during sleep. This condition is known as obstructive sleep apnea (OSA).

Complications: Tonsil-related complications such as peritonsillar abscess (a collection of pus around the tonsils) or difficulty swallowing due to enlarged tonsils.

Suspected Tonsil Cancer: In cases where there is concern about cancerous growth on the tonsils, a tonsillectomy may be performed for biopsy and treatment.

The procedure is typically performed under general anesthesia, and Mr Farnan uses two primary techniques for removing the tonsils: Electrocautery, or coblation.

A bipolar scissor tonsillectomy is a surgical procedure used to remove the tonsils. This method involves the use of bipolar electrocautery scissors to cut and excise the tonsils. Bipolar electrocautery is a technique that uses electrical current to cut tissue and simultaneously coagulate (seal) blood vessels, reducing the risk of bleeding during and after the procedure.

Here's an overview of the bipolar scissor tonsillectomy procedure:

Anesthesia: The procedure is typically performed under general anesthesia, which means the patient is completely asleep and pain-free during the surgery.

Bipolar Scissor Technique: The surgeon uses specialized bipolar scissors that have two electrodes, one at each blade of the scissors. These scissors can both cut and cauterize tissue at the same time. The surgeon carefully dissects the tonsils from the surrounding tissue and removes them.

Hemostasis: The bipolar electrocautery technique helps control bleeding during the procedure by sealing blood vessels as the tissue is cut. This minimizes the need for additional cauterization or the use of sutures to stop bleeding.

Post-Operative Care: After the tonsils are removed, the patient is closely monitored during the initial recovery period. Pain management and post-operative care instructions, such as eating a regular diet, staying hydrated, and taking pain medications, are provided.

Coblation tonsillotomy, also known as coblation tonsil reduction, is a surgical procedure that involves using coblation technology to reduce the size of the tonsils without completely removing them. Coblation stands for "controlled ablation" and is a minimally invasive surgical technique that uses radiofrequency energy to precisely and gently remove or shrink tissues.

In coblation tonsillotomy, the surgeon uses a specialized coblation wand that emits radiofrequency energy at a relatively low temperature. This energy creates a plasma field around the wand's tip, allowing the surgeon to target and break down the tissue while minimizing damage to surrounding healthy tissue. This technique is often used to address specific problems related to enlarged tonsils without completely removing them.

Coblation tonsillotomy may be considered in cases where the tonsils are causing symptoms such as snoring, sleep-disordered breathing, or recurrent throat infections, but complete tonsillectomy (removal) may not be necessary or desired. It is typically a less painful procedure than traditional tonsillectomy, and the recovery time is often shorter.

What is the recovery like after tonsillectomy?

Recovery after a tonsillectomy can vary from person to person, but there are common experiences and a general timeline for the recovery process. Here's what you can expect:

Immediate Post-Operative Period (First Few Hours):

After the surgery, you'll be monitored in a recovery area until you're fully awake and stable. This period typically lasts a few hours. You may experience some grogginess, sore throat, and mild pain, which is managed with prescribed pain medications. It's crucial to stay well-hydrated, and you'll be encouraged to start drinking liquids when you can tolerate them.

First Few Days After Surgery: Sore throat and pain are common during this period. Pain is usually at its worst around days 3-7 post-surgery. Difficulty swallowing and a "scratchy" or "dry" feeling in the throat are typical. Patients are encouraged to eat a normal diet as soon as possible after surgery, but avoid spicy foods that may cause irritation. You may experience ear pain due to referred pain from the throat. Pain medications will help alleviate this discomfort.

Swelling and Bruising: Swelling in the throat, in particular the uvula, is common after a tonsillectomy but typically peaks 2-3 days after the surgery.

Recovery at Home (First Two Weeks): It's essential to rest and avoid strenuous activities during this time. Continue to drink plenty of fluids to stay hydrated. Follow your surgeon's post-operative care instructions, including taking prescribed medications and avoiding certain foods, like spicy or hot foods that can irritate the throat. Be prepared for fluctuations in pain and discomfort during this period.

Return to Normal Activities: Most patients can return to work or normal daily activities after 14 days. Avoid strenuous exercise and heavy lifting for several weeks. You may feel fatigued for a few weeks after the surgery.

Long-Term Recovery: Full recovery from a tonsillectomy can take several weeks to a couple of months. It's important to attend follow-up appointments with your surgeon to monitor your progress. While the initial discomfort and sore throat should improve significantly within a couple of weeks, it can take a bit longer for the throat to fully heal.

What are the risks of tonsillectomy?

Tonsillectomy is generally considered a safe and common surgical procedure. However, like any surgical intervention, it carries potential risks and complications. It's essential to be aware of these risks and discuss them with your healthcare provider before undergoing the procedure. Some of the possible risks and complications of tonsillectomy include:

Bleeding: One of the most common complications of tonsillectomy is postoperative bleeding. While some oozing and small amounts of blood in saliva are expected during the first few days, significant bleeding is a rare but serious risk that may require medical attention.

Infection: Although tonsillectomy is often performed to treat recurrent throat infections, there is still a risk of infection after the surgery.

Pain: Postoperative pain is normal and expected, but for some individuals, it can be severe and last for several days to a week.

Dehydration: Pain and discomfort in the throat may make it difficult to drink enough fluids, which can lead to dehydration.

Anesthesia Risks: Like any surgical procedure, tonsillectomy carries potential risks associated with anesthesia, such as allergic reactions or adverse effects.

Swelling: Swelling in the throat and neck area is common after tonsillectomy, but excessive swelling could cause breathing difficulties.

Changes in Taste: Some individuals may experience temporary changes in their sense of taste or smell after the surgery.

Regrowth of Tonsil Tissue: In rare cases, tonsil tissue can partially regrow after a tonsillectomy, leading to the return of symptoms.

Adverse Scarring: Scarring is usually minimal, but in some cases, it may affect the throat or voice.

Unsatisfactory Results: Tonsillectomy may not always provide the desired or long-lasting relief from recurrent infections or other symptoms.

Mr Farnan can provide guidance on the benefits and risks of the procedure and help you make an informed decision. Following the surgeon's post-operative care instructions is crucial to minimize the risk of complications and ensure a smooth recovery.

How long should I take off work or school after tonsil surgery?

In most cases Mr Farnan recommends taking two weeks of work, or school to recover after tonsil surgery. In the case of coblation surgery however, patients may recover more quickly and it is not unusual for children to be fit to return to school after 1 week.