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When your tonsils are a pain in the neck: Should you consider tonsillectomy?

Posted on Mar. 19, 2018 ( comments)

With the end of cold and flu season in sight, many patients are coming to ear, nose and throat (ENT) clinics to seek remedies for multiple recurrences of severe sore throat, strep throat episodes or chronic low-grade tonsil infections developed over the fall and winter.

Frequent or chronic throat infections may affect productivity at work or school and lower overall quality of life. Remedies such as oral antibiotics may only be partially or temporarily effective and may harbor significant side effects over several courses.

Surgery to remove tonsils is often a last resort option for cases with severe or highly frequent infections. But sometimes tonsils should come out — if the benefits outweigh the risks.

Here are some answers to commonly asked questions about tonsils and tonsil surgery:

What are tonsils?

Tonsils are clumps of tissue in the throat (one on each side) that contain a collection of immune cells (lymphatic tissue). They typically enlarge during upper respiratory infections and may at times become painful.

Enlarged tonsils without any symptoms are common among kids. Left alone, enlarged tonsils may eventually shrink on their own over the course of several years. While enlarged, tonsils may obstruct breathing, particularly at night.

What is tonsil surgery?  

Surgical removal of the tonsils is one of the most common operations performed on children and adults in the United States. It’s performed under general anesthesia (completely asleep in an operating room) and can take about 20 minutes. Tonsil surgery is done through the mouth without any external incisions. Recovery times vary, but they can last about seven days in younger children and 10-14 days or longer in teenagers and adults.

Interested in learning more about tonsil surgery or other treatments?
Find an ENT provider

What are the risks of surgery?  

Tonsil procedures are not without risk, bleeding being the most serious risk. This can happen up to two weeks after surgery in up to 3 percent of children/adults. It’s extremely rare that patients need a blood transfusion or additional surgery. All children and adults experience throat discomfort or pain for several days, up to three weeks for adults.

When is surgery necessary?  

Sometimes the tonsils should come out. But the benefits must outweigh the risks. All of the following are valid reasons for evaluation:

  1. Severe snoring and obstructive sleep apnea (most common reason in children)
  2. Recurrent/chronic infections or tonsil stones (most common reason in adults)
  3. Difficulty eating meat or chewy foods
  4. Recurrent abscess (deep infection) of the tonsil
  5. Suspected tumor of the tonsil

What about when tonsils are not painful or infected but are very large?

This is a scenario that is most common in young children and is an important reason to consider tonsillectomy. Obstruction of the throat can lead to sleep apnea, which may have repercussions on children’s behavior, growth and development.

Interested in learning more about tonsil surgery or other treatments?
Find an ENT provider

About The Author

Oliaei_Sepehr Sepehr Oliaei, MD

Sepehr Oliaei, MD, is an otolaryngologist (ear, nose and throat specialist) at MultiCare ENT, Sinus & Allergy Specialists - Tacoma. To schedule an appointment or evaluation, call 253-403-0065.

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