MedClinic > Blog > ENT > Tonsillectomy


Tonsillectomy is a surgical operation that is resorted to in the treatment of a chronic form of tonsillitis in children. The procedure involves a complete excision of the tonsils, which are called glands in everyday life. For adults, tonsillectomy is rarely used. It is resorted to only after all possible conservative methods of eliminating the infection had not given the proper result.

Indications for tonsillectomy:

  • exacerbation of tonsillitis (acute tonsillitis) two or more times in the last year;
  • snoring caused by abnormal proliferation of lymphoid tissue in nasopharynx;
  • history of peritonsillar abscesses;
  • unsatisfactory results of conservative therapy, situations when repeated antibiotic courses, debridement (rinsing) of the tonsils and physical procedures do not help achieve stable remission;
  • reactive arthritis as a chronic form of inflammatory joint damage;
  • rheumatism (acute non-purulent inflammation) or chronic rheumatic heart disease (it can be heart failure, myocardial inflammation, change of the structure and function of the valves), provoked by streptococcal flora;
  • kidney diseases: (pyelonephritis, post-streptococcal glomerulonephritis or the development of chronic renal failure);


Classical tonsillectomy

The patient receives general anaesthesia by putting into a deep sleep with medications, during which he does not feel pain. During the action of anaesthesia, the surgeon excises the tonsils with surgical instruments. To avoid large blood loss, vascular coagulation is performed. This type of treatment is radical – the source of infection is eliminated, this guarantees the absence of relapses of tonsillitis in the future. The postoperative period is accompanied by moderate pain.

Laser tonsillectomy

The operation is performed using an infrared or fibre optic surgical laser. The mode of action of these tools lies in cutting off the tissues by strong heating. Coagulation of blood vessels is carried out in the same way. The process takes much less time than with the classical methodology – only about 30 minutes. Laser tonsillectomy is accompanied by much less blood loss. The only disadvantage of this type of surgery is the increased risk of burning of the mucous membranes and, possibly, a slightly longer healing stage.

Coblation tonsillectomy

Coblation, or cold destruction, is one of the most modern and advanced methods of treatment in otolaryngology. The main tool is a radiofrequency generator, an apparatus that creates plasma using two electrodes and a saline solution. The action of a magnetic field can heat it to 45-60 ° C and cause irreversible changes: proteolysis (decay of proteins), water and low molecular weight nitrogen compounds.

Cold plasma tonsillectomy is performed under general anaesthesia – it takes minimal time, there is practically no blood loss, and the rehabilitation period is minimal.

Preoperative preparation:

Before a patient is placed in a hospital, he must undergo a series of laboratory tests and functional tests:

  • complete blood count;
  • blood biochemistry;
  • blood coagulation analysis;
  • general urinalysis;
  • blood type analysis and Rh factor;
  • chest x-ray;

Preoperative diagnosis is required. It depends on her whether complications can be avoided subsequently. In the course of these investigations, you can find out whether the patient has concomitant diseases, how tonsillitis occurred, which should be taken into account during a tonsillectomy.

If necessary, the list of tests can be expanded by the attending physician. In some cases, patients with chronic tonsillitis need additional consultation with a pulmonologist or cardiologist.

Anaesthesia can be local and general. Experienced anaesthetists give preference to the latter option, as during the operation the patient will be at rest. This will allow the doctor to work in comfortable conditions, to conduct tonsillectomy as quickly and efficiently as possible.

Preparation: on the eve of the operation, you need to give up alcohol and smoking, do not overeat the night before. Take convenient things with you to the hospital: it can be a tracksuit, T-shirts made of natural fabric, and replaceable underwear. It is also worth taking shoes, slippers, and personal hygiene products. In order not to be bored, you can take a book or laptop with you, since after the operation you will have to spend another 1-2 days in the hospital. It is better to warn medical personnel about valuable things in advance or give them to relatives for the duration of the operation.

Day of operation

The patient is being prepared for surgery, anaesthesia is administered only on an empty stomach since a suitable dose can be calculated only this way. The last meal should be at least 6 hours before surgery, and it should be very light food: low-fat broth, meat or fish, fruits and vegetables. There are also restrictions on the intake of water – you can drink a maximum of 400 ml 4 hours before surgery.

The most unpleasant part of general anaesthesia is intravenous injection. There will no longer be any pain or discomfort. So that you do not fall from the operating table, you will be tied tightly.

Recovery period and recommendations

Be sure to follow all the doctor’s instructions, since if complications occur, then it is usually at home. For each patient, medications are individually selected on the day of discharge. You should monitor your condition, whether you feel better, whether there are side effects that were warned about in the hospital. After tonsillectomy, 2-3 and 9-11 days are considered the most dangerous.

For the period of rehabilitation, it is necessary to exclude overheating (saunas, baths), consuming hot food, physical activity. You can limit yourself to a warm shower and walks in the fresh air.