What Is Tonsil Surgery (Tonsillectomy)?
Tonsil surgery, namely tonsillectomy, although performed less frequently in recent years, is one of the most commonly performed surgeries worldwide. The tonsils are bilateral lymphatic organs involved in immunity, present in every person from birth, located at the junction of the mouth and throat, and have certain functions in protecting the upper respiratory tract. However, if the tonsils cannot perform these functions for various reasons or if they cause certain other disorders, they must be surgically removed. Tonsillectomy surgeries are generally performed during childhood, although they are also rarely performed in adulthood. Although tonsil surgeries have decreased in recent years, they are still among the surgeries performed quite frequently in our country and worldwide.
Does removing a lymphatic organ through tonsil surgery harm the body?
In people whose tonsils have been removed, there is no significant increase in respiratory tract infections because other lymphatic structures involved in immunity also become active. In addition, since the tonsils in patients who require surgery are already unable to perform their role in the immune system, removing the tonsils does not cause a health problem for the person. This is because many lymphatic structures in the upper respiratory tract and various other tissues that play a role in the body’s immunity apart from the tonsils will continue to perform their functions.
Conditions Requiring Tonsil Surgery (Indications):
- Recurrent acute infections (more than five attacks per year or more than three attacks per year for two consecutive years)
- More rarely, recurrent infection accompanied by heart valve diseases and febrile seizures
- Conditions in chronic tonsillitis that do not respond to treatment: bad breath, persistent sore throat, painful enlargement of the lymph nodes in the neck, infection carriage that does not respond to medical treatment, development of an abscess around the tonsils, enlargements causing obstruction in the throat, snoring, and chronic mouth breathing
- Tonsils large enough to cause sleep apnea syndrome
- The presence of the following conditions together with enlargement of the tonsils: Increased pulmonary blood pressure disease, feeding difficulty, speech disorders, developmental delay, development of jaw closure (occlusion) disorder, developmental disorders of the facial bones (craniofacial), suspicion of a tumor (asymmetrical or suspicious-looking tonsil enlargement)
After What Age Is Tonsil Surgery Performed?
It is recommended that children requiring tonsil surgery be followed until the age of 4-5 and controlled with medication treatments. The reason for this is the risks of postoperative feeding difficulties and emergency intervention in cases of bleeding in very young children. In addition, considering the average blood loss occurring in standard tonsil surgery, it is recommended that these surgeries not be performed in children weighing less than 10 kg. In other words, considering the contribution of the tonsils to the development of the body’s defense system (immune system), especially in children under the age of 4, it is recommended to delay surgery unless there is enlargement severe enough to cause airway obstruction, or to reduce excessively large tonsils with radiofrequency. Once children are over the age of 4-5, there is no objection to performing tonsil surgery at any age with the correct indications.
What Are the Complications of Tonsil Surgery (Undesired Surgical Conditions)?
Although there are very, very, very rare complications related to tonsil surgery such as trauma to the vessels and nerves around the tonsils, jaw joint trauma, and trauma to the cervical vertebrae, the most common problem encountered is postoperative bleeding.
Bleeding is most commonly seen within the first 24 hours. Another risky period is the 7th-14th days, when the white healing tissue formed in the surgical area sheds. Therefore, the first 2 weeks following surgery are critical in terms of nutrition. It is important to inform patients that they must urgently apply to the hospital if bleeding occurs at any time. In bleeding after this surgery, it is generally necessary to evaluate the patient under anesthesia, identify the bleeding sites, and stop the bleeding using the appropriate method. It would be appropriate for patients treated in this way to be hospitalized and monitored for at least one day.
Recovery Process After Tonsil Surgery:
During the first 2-3 days after surgery, mild pink-colored bleeding mixed with saliva may normally occur. Inform your doctor if fresh red blood or bloody vomiting occurs.
Pain: It is natural to have some pain for 2 weeks after surgery. In general, pain is less severe and shorter in children and decreases significantly within 3-4 days. Pain occurs especially during swallowing and may radiate to the ear.
The severity of pain may vary from person to person. Simple painkillers are generally sufficient, but stronger pain-relieving medications may need to be used in some people.
Nutrition Information: During the first 4-6 hours after surgery, it is not appropriate for the patient to eat or drink because they have not fully recovered from the effects of anesthesia. Your nurse will inform you, according to your doctor’s instructions, when you may begin taking food by mouth.
In general, plenty of cold water should be consumed, and soft, lukewarm, and non-irritating foods should be eaten.
REMEMBER: During the 2-week period after surgery, you may not be able to swallow food comfortably without the help of pain-relieving medications.
Additional Nutritional Recommendations After Tonsil Surgery:
- Avoid acidic products (cola beverages, orange juice, lemon juice, etc.)
- Do not use a straw (to avoid directing hot food directly onto the tonsils)
- Drink plenty of fluids (it is important not to become dehydrated)
- Ice cream is recommended both because it contains protein and because of its temperature
- Avoid red- and brown-colored foods and beverages as much as possible (they may be confused with bleeding)
- Avoid hot and spicy foods
What Should the Nutrition Program Be Like After Tonsil Surgery?
The day of surgery and the first 3 days after surgery: Small amounts but frequent intervals of liquid and cold (or room-temperature) foods: water, milk, fruit juices, compote, sherbet, ice cream, strained soup, iced tea, ayran, especially ice cream because its cold temperature relieves pain and because of its protein content (it should definitely be preferred without additives such as pistachios)
Postoperative days 3-7: In addition, semi-solid but definitely cold (or slightly lukewarm / never hot) soft foods such as yogurt at room temperature, starch pudding, puree, pasta, pudding, bread added to milk, and eggs mixed into yogurt
After the 7th postoperative day: A normal diet may be started provided that it is not irritating or very hot. During the first 2 weeks, foods such as hard bread crusts, crackers, and biscuits, which carry a risk of pricking and irritation, should not be consumed. Eating should be slow so as not to cause irritation in the throat. The most dangerous thing that may cause bleeding during this period is coughing.
CAUTION: SINCE PERSISTENT COUGHING AFTER SURGERY MAY CAUSE BLEEDING, YOU MUST CONTACT YOUR DOCTOR IN THIS SITUATION!!!!!!!!!!!!!
What Problems Are Considered Normal After Tonsil Surgery?
Speech: It is normal for your speech to sound nasal after surgery, and this condition may last for up to 3 weeks. This problem rarely lasts longer and generally responds to treatment. The volume of the air cavity in the throat plays a role in voice formation; therefore, depending on the size of your tonsils, a slight permanent change in your tone of voice may occur after surgery.
Fever: It is normal for your temperature to increase by 1 degree after surgery. Higher and prolonged fever is generally caused by dehydration. If your fever remains high despite drinking plenty of fluids, call your doctor.
Bad Breath: A white, dirty-gray membrane will form in the surgical area, and bad breath may occur because of this; this is normal. This membrane is part of the natural healing process and disappears within approximately 2 weeks.
Rarely, especially in people who drink little fluid and are inadequately nourished, the surgical site may become inflamed and a worse odor may develop in the breath. Inform your doctor of this condition.
Physical Activities After Surgery: Children should rest at home for 2-3 days after surgery. They may return to school 6-7 days after surgery. They should not participate in sports activities for at least 21 days.
Adults may begin working following a follow-up examination 7-10 days after surgery. They should avoid sports and strenuous activities for two weeks.
Bathing and Showering: Starting from the 3rd-4th day after surgery, bathing may be done with lukewarm water for the first 15 days.
What Is the Cost of Tonsil Surgery?
Tonsil surgeries are among the surgeries fully covered by the Social Security Institution in our country. Therefore, they can be performed completely free of charge in all public and public-affiliated hospitals and private hospitals contracted with the Social Security Institution. In addition, many private health insurance policies may also cover the surgery costs with provision approval.
If you plan to have tonsil surgery in a fully private hospital that is not affiliated with the Social Security Institution, the cost will vary according to the hospital and the surgeon. However, we can say that tonsil surgeries in our country can be performed under fully private hospital conditions at an average price ranging from 30,000 TL to 80,000 TL. However, these prices may vary according to the surgeon and hospital facilities.
Which doctor and surgeon should I consult for tonsil surgery?
Surgeries involving the tonsils and adenoids fall within the specialty of ear, nose, and throat (ENT) and are performed by specialists in this field. I recommend that you prefer a doctor who is particularly involved in these types of surgeries when considering tonsil surgery. Especially in recent years, as in every specialty, many specialist physicians have emerged in the ENT field who are interested only in ear surgeries or nasal and facial aesthetic surgeries. Therefore, nowadays not every ear, nose, and throat specialist may perform tonsil surgery. The reason is that these physicians want to specialize and focus particularly on one region or one subject. In this respect, you should prefer doctors who have operated on people similar to you or your child and who have positive references and reviews on websites.
Another point to consider when choosing a surgeon for tonsil surgery is that you should be able to reach the surgeon 24/7. This is because tonsil surgery may cause bleeding, sometimes very severe bleeding, not only during the first week but even for 3 weeks after the initial surgery. During this period, you must be able to reach the doctor who performed the surgery, day or night. This is because especially when bleeding begins in a small child and you take your child to the emergency department, the emergency physician may not be able to intervene very much. In such a situation, in cases of bleeding after tonsil surgery, an ENT specialist may need to intervene urgently under operating room conditions. To avoid difficulty and danger during this process, I recommend choosing a good ENT specialist who is preferably close to your home and whom you can easily reach in emergencies.
Important note: Our tonsil surgery blog is for informational purposes only
In order to provide you with better service and work with greater focus, we also chose to deal only with nasal surgeries. Therefore, in our clinic, from 2017 to the present, in order to provide you with better service, only rhinoplasty services have been provided, and we have tried to focus only on rhinoplasty surgeries. Apart from this, we do not provide general Ear, Nose, and Throat examination and treatment services. This blog is for general informational purposes, and we have shared our theoretical suggestions and recommendations regarding tinnitus. We recommend contacting our colleagues who deal with this subject for the follow-up and treatment of tonsil surgery.
Frequently Asked Questions
What Is Tonsil Surgery?
Tonsil surgery (tonsillectomy) is the surgical removal of the tonsils due to frequently recurring tonsil infections, breathing problems, or other medical reasons.
In Which Conditions Is Tonsil Surgery Performed?
Surgery may be recommended in cases of frequently recurring tonsillitis, sleep apnea, tonsils enlarged enough to obstruct breathing, difficulty swallowing, and certain chronic infections.
How Is Tonsil Surgery Performed?
The surgery is generally performed under general anesthesia. Since the tonsils are removed through the mouth, no external incision is made and no scar forms on the skin.
How Long Does Tonsil Surgery Take?
Although the duration of surgery varies according to the patient’s condition, it is generally completed within 30 to 60 minutes.
What Is the Recovery Process Like After Tonsil Surgery?
The recovery process lasts 10 to 14 days in most patients. During this period, sore throat, difficulty swallowing, and mild fatigue may be experienced.
How Should Nutrition Be After Tonsil Surgery?
Plenty of fluids should be consumed during the first few days, and soft, lukewarm, or cold foods should be preferred. It is recommended to avoid hard, spicy, and very hot foods for a while.
Is Pain Normal After Tonsil Surgery?
Yes, sore throat and pain radiating to the ears may occur after surgery. These complaints can generally be controlled with painkillers recommended by the doctor.
Are There Risks Associated with Tonsil Surgery?
As with every surgical procedure, bleeding, infection, anesthesia-related complications, and rarely problems related to the healing process may occur.
When Can Daily Life Be Resumed After Tonsil Surgery?
Most patients can return to their daily activities within approximately two weeks. However, the period recommended by the doctor should be followed for strenuous physical activities.
What Should Be Considered After Tonsil Surgery?
It is important to drink plenty of fluids, use the medications prescribed by the doctor regularly, rest, stay away from smoking and irritating environments, and apply to a healthcare institution without delay if signs of bleeding occur.
