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Tonsillectomy

What are tonsils?

Tonsils are lymphoid tissue located in the back of the throat. It is only during the first few months of life that they are an important part of the body's immune system. Children and adults who have their tonsils removed usually have less upper respiratory infections.

Why are tonsils removed?

The main reasons for a tonsillectomy (surgical removal of the tonsils) are recurrent infections and/or obstructive sleep apnea (OSA).

Six (6) episodes of tonsillitis per year, (causing one to miss 20 days of school or work per year), is considered to be an indication for tonsillectomy. Recurrent peritonsillar abscess is another indication.

Very large tonsils (and adenoids) can cause obstructive sleep apnea (OSA). Typically, someone with OSA snores very loudly, then becomes silent for about 10 seconds (despite an effort to breath), then gasps for air, and then starts snoring again. People with OSA may be very tired during the daytime and/or irritable.

Occasionally, tonsils are removed because a tumor is suspected.

What are the risks of tonsillectomy?

Tonsillectomy is considered major surgery. The main risk is bleeding, which can be serious. About 5% of patients bleed after surgery (and might need to return to the operating room to have the bleeding stopped). Most bleeds occur 7 to 10 days after surgery, but rarely, a bleed can occur as late as 17 days after surgery.

Before surgery, the patient should discuss with their otolaryngologist any tendency they may have to bleed excessively. They should also discuss the need to avoid aspirin, ibuprofen and other blood thinners, ideally for several weeks before and after the surgery.

After the surgery, the individual should avoid eating things like chips as well as avoid playing sports for 2 weeks. They should not plan any trips that would take them far from the hospital or out of the country for at least 3 weeks after surgery.

If there is any spitting or vomiting of blood (which can look bright red, dark red or black), they must seek immediate medical attention and, if necessary, call 911.

The otolaryngologist will also discuss methods of pain control, the need for a soft, non-acidic diet, and how to prevent dehydration.

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