Tonsillectomy refers to the surgical removal of the tonsils indicated in conditions of recurrent infections and when the tonsil inflammation results in sleep disturbances. Tonsils are round, fleshy masses at the back of the throat concerned with filtering germs inside the throat and thus frequently subjected to pathogen attacks. Sore throat, cold, and recently covid related influenza are common causes of tonsillitis that is either treated with antibiotics or goes away on its own. When tonsillitis becomes severe and starts impacting your quality of life is when surgeons advise its removal.
How is Tonsillectomy conducted?
Tonsillectomy is among the most frequent surgeries performed on adults and children annually and is a low-risk procedure conducted under general anesthesia.
Before the procedure, you are required to stop taking certain medications and not eat or drink anything after midnight before the scheduled surgery.
During the surgery, the surgeon will surgically remove the tonsils, of which you will not be aware because of the sedative effects of the anesthesia.
After the surgery, you are shifted to a ward, monitored until your anesthetic effects wear off, and discharged on the same date. The wounds heal without stitches, and you can resume your normal activities within 2-6 weeks.
Signs that you need a tonsillectomy
Constant throat irritation
Chronic recurrent tonsillitis can result in the breaking up of the abscess in the throat and spreading to the lungs, leading to pneumonia complications. Usually, tonsillitis is virus-induced. But bacterial tonsillitis, e.g., Streptococcal Tonsillitis, can result in kidney complications. Patients with elevated antistreptolysin O (ASO) titers (ASOT) (blood test used to detect Streptococcus bacteria) and recurrent tonsillitis e are at increased risk of rheumatic heart disease (RHD).
Studies have shown that patients with seven or more episodes of tonsillitis in one year, five or more episodes in the previous two years, and around three episodes in the past three years should consider getting a tonsillectomy for long-term relief.
You have bacterial tonsillitis that doesn't respond to antibiotics.
Usually, antibiotics are the only treatment options for bacterial tonsillitis episodes that are either administered orally or, in severe cases, injected intravenously when the infection is severe.
Unfortunately, you might still have an infection after taking the medications because of an immunocompromised system or antibiotic-resistant bacteria. In such conditions, surgical removal of the tonsils or Tonsillectomy is advised. Removal of the tonsils does not compromise the immune system in adults. Instead, clinical trials have proved that tonsillitis can reduce doctor visits and result in fewer missed days at work.
Difficulty Sleeping
The average tonsil size is 42.81 cubic cm, which can be smaller or larger and vary from person to person. Usually, tonsils are graded from 0-4 based on size where
They are already removed
They are barely visible
They are normal
They are significant and touch the uvula of the throat
They are touching or overlapping the uvula or kissing each other
Grade 4 tonsils in children can result in abnormally loud snoring and cause difficulty swallowing foods, while in adults, they can lead to Obstructive Sleep Apnea. In such conditions, physically removing the enlarged tonsils immediately opens up space for breathing and improves sleep apnea.
Sleep Apnea is a severe problem that, left untreated, can increase the risk of type-2 Diabetes and insulin resistance. Studies have shown that people with severe sleep apnea have frequent breathing pauses during sleep and are at increased risk of dying due to breathing complications in comparison to people who don't have sleep apnea. Tonsillectomy procedures are considered an emergency and significantly improve symptoms within six months of surgery.
Halitosis
Halitosis or oral malodor is the term used to describe noticeably unpleasant odors exhaled during breathing, irrespective of whether the smell is from an oral source. Poor oral hygiene is one of the chief causes of halitosis. But it can also occur from chronic tonsillitis because it inflames the mucous membranes and makes them cause a foul odor. Additionally, inflamed tonsils result in bits of food and plaque sticking to the tonsils, resulting in bad breath as they decompose.
In such conditions, Tonsillectomy is a significantly effective procedure in treating halitosis caused by chronic tonsillitis. Studies have shown halitosis improvement in 70% of subjects within four weeks of Tonsillectomy, which increased to 79.5% in the next eight weeks.
Cancerous Growth
Tonsil cancer results in abnormal growth of cells forming the tonsil resulting in difficulty swallowing and the sensation of something caught in your throat. A persistent sore throat is among the common symptoms of tonsil cancers with asymmetrical tonsil appearance that eventually develops into ear pain and enlarged lymph nodes.
Fortunately, tonsil cancer is treatable when detected early and has a survival rate of 85-90%. Tonsillectomy is the primary treatment method for tonsil cancer, combined with radiation and chemotherapy. Other than tonsil cancer, Tonsillectomy is also recommended for tonsil stones, i.e., lumps of calcified material in the tonsils caused b oral bacteria that cause bad breath and lumps in the throat.
Who is not a good candidate for Tonsillectomy?
Even when the tonsils are impacting your health, Tonsillectomy is not an option in
Children under three years of age
You have tonsillitis less than four times a year.
You respond poorly to anesthetics, are anemic, or have bleeding diathesis ( tendency to bleed or bruise easily )
You have a small mouth or oral complications that will interfere with the surgical procedure.
Can I prevent Tonsillitis?
Some of the precautions that can prevent tonsillitis and subsequent Tonsillectomy are
Avoid contact with patients suffering from sinusitis and tonsillitis. Even if tonsillitis isn't contagious, the viruses spread because the condition is contagious, and it would avoid physical contact.
Do not share your utensils, towels, or hygiene-related things like soaps with them or use their stuff, as there is a high chance of contamination.
Children are at a high risk of tonsillitis because of their immunocompromised nature. Teach them hygiene habits like washing hands before, after meals, and after coming from outdoors, along with practicing it yourself
Wear a face mask when going outside for your safety and that of others.
Cover your nose when coughing or sneezing.
Conclusion
In conclusion, you should always consult with a doctor if any signals of tonsillitis, such as swelling and difficulty swallowing, arise. Early detection and treatment is key when dealing with a tonsillectomy. A tonsillectomy may be a scary option for many adults due to the possible mild discomfort associated with the procedure; however, once the recovery process is complete you may find yourself feeling much better and enjoying improved respiratory function long-term. While reviewing your options and deciding which course of action to take can feel intimidating in the moment, it's worth gathering as much information as possible so that you can make an informed decision about whether or not to get a tonsillectomy. Remember that no matter what path you choose, there are medical professionals available who are here to help you every step of the way.
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