What is the success rate of surgery?
- Removing the tonsils is completely effective in stopping tonsillitis.
- But you can still get ordinary sore throats. They will not be as bad as tonsillitis.
- Removing the adenoids is very effective at restoring the ability to breathe through the nose, unless it is blocked for some other reason e.g. allergy or sinusitis.
- Adenoidectomy is about 70% effective in treating glue ear, but the beneficial effect takes several months to develop.
What are the risks of surgery?
Tonsillectomy and adenoidectomy are very safe procedures in modern medical practice. But no operation is totally risk free.
- At worst, you could die or suffer brain damage – but you are more likely to be injured in a road accident. A general anaesthetic carries a minimal risk, with consultant anaesthetists using modern drugs and monitoring equipment.
- There is a risk of excessive bleeding, either during or up to two weeks after the operation.
- About 2% of patients may need a second operation to control bleeding, readmission to hospital, or a blood transfusion.
- Most serious bleeds happen in the first few hours after operation.
- During this recovery period, trained nurses will monitor your condition carefully.
- There is a risk of picking up an infection in the recovery period. Infection is more likely if you don’t eat and drink properly. That is why you should make sure you take painkillers half an hour before meals, so that it won’t be too sore to swallow.
- If you do get an infection, you may get some further bleeding and might need antibiotics, or you might need to be re-admitted to hospital for treatment.
- Your voice will change character after removing the tonsils or adenoids, ususally for the better, but some might not like it.
- There may be some numbness of the tongue or side of the mouth. This will normally be temporary, occasionally it is permanent.
- There may be some change in the sense of taste. This will normally be temporary, occasionally it is permanent.
Is the operation more dangerous in adults?
No. Tonsillectomy is relatively safe at any age, but it is more painful in adults and teenagers than in young children. There are no absolute age limits. The youngest patient I have operated on was six months, for breathing obstruction. The oldest was 93, for cancer of the tonsils.
Position for removal of tonsils and adenoids under general anaesthetic
How is the operation done?
Tonsils and adenoids are removed under general anaesthetic (fully asleep) in the operating theatre. The anaesthetist usually sends you to sleep by giving an injection. The drug injected acts very rapidly, within a few seconds. To stop the needle from hurting children, the ward nurse puts special cream on the back of the hand. It numbs the skin, so the needle doesn’t hurt. Sometimes, if a vein can’t be found or the child is too frightened, we send you to sleep with gas. This may take several minutes to work. Once you are asleep, the anaesthetist puts a plastic tube in your mouth. It goes to the trachea (windpipe) so that you can breathe during the operation. A special gag holds the mouth wide open. Both tonsils and adenoids are removed through the mouth. There is no external cut. Any excessive bleeding is controlled by a combination of pressure swabs, diathermy (electric cautery) and stitches. If you do need stitches, they will be self-dissolving. They will not need to be removed.