Tonsillectomy

Tonsillectomy is the surgical removal of the tonsils, two oval-shaped pads of tissue at the back of the throat. It is one of the most common surgeries performed on children, though adults also undergo the procedure. Approximately 530,000 tonsillectomies are performed annually in the US.

The procedure is recommended for recurrent tonsillitis (7+ episodes in one year, 5+ per year for two years, or 3+ per year for three years), peritonsillar abscess, obstructive sleep apnea caused by enlarged tonsils, difficulty swallowing, and tonsil stones causing persistent bad breath.

Fast for at least 8 hours before surgery. Stop blood-thinning medications as directed. Stock up on soft foods and ice pops for recovery. Arrange for 10-14 days of time off from school or work.

Under general anesthesia, the surgeon removes the tonsils using various techniques including cold knife dissection, electrocautery, coblation, or microdebrider. The procedure takes 20-30 minutes. Bleeding is controlled with cauterization.

Throat pain is significant for 7-14 days and is managed with pain medication. Eat soft, cool foods and stay well hydrated. Scabs form in the throat and fall off around days 7-10, which can cause minor bleeding. Most patients return to normal activities in 2 weeks.

Risks include bleeding (3-5% of cases, can occur up to 14 days post-surgery), dehydration from pain-related reduced intake, infection, changes in voice quality, and rare anesthesia complications.

Alternatives include watchful waiting (tonsillitis episodes may decrease over time), long-term low-dose antibiotics, and partial tonsillectomy (tonsillotomy) which preserves some tonsil tissue and may result in less pain.

Covered by most insurance plans when medical necessity criteria are met. Documentation of recurrent infections or obstructive sleep apnea is required. Pre-authorization may be needed.