Having your tonsils removed is a surgical procedure called a tonsillectomy. Reasons you may need to have your tonsils removed include: frequent infections (episodes of tonsillitis, usually 7 or more in 1 year), difficulty breathing or swallowing, sleep apnea, or any growths on the tonsils.
Before Having Your Tonsils Removed
Tonsillectomies are performed under general anesthesia. You will be completely asleep and will not be able to feel pain during the procedure. You will not be able to eat before surgery. This is because there is a risk of vomiting with anesthesia. Your physician or nurse will give you exact instructions about when to stop eating and drinking. In addition to not eating or drinking, you should not smoke, chew gum, or suck on mints or candy.
Tonsillectomies are mostly performed in same day surgery settings. This means that you will go home the same day that you have your tonsils removed. You should wear loose comfortable clothing to the surgical center. Arrive on time. In some cases a medication called Versed can be given prior to the procedure to reduce anxiety, especially in small children. If you have other health problems, your doctor may order blood work or other tests before the surgery. If you are a woman of childbearing age (usually age 12 to 55 unless you have had a hysterectomy), it is mandatory that you have pregnancy test before the surgery. This requires a small amount of urine.
If the patient is a child and has a comfort item such as a blanket or a favorite toy, bring it with you. Also, if your child drinks from a bottle or special cup bring it along so your child can drink after the surgery. Make sure you bring comfortable clothing and extra diapers or underwear.
Prior to having your tonsils removed, you will need to remove any metal from your body including jewelry, retainers or body piercings. You will also need to remove contact lenses, dentures and hearing aids.
You will also need to refrain from medications that have the ability to thin your blood for 1 to 2 weeks before surgery. These medications include aspirin, ibuprofen, Coumadin, Plavix, and large doses of vitamin E. Follow your physicians instructions for taking any scheduled medications on the day of surgery, especially if you are on insulin or blood pressure medications.
Methods of Having Your Tonsils Removed
- Cold Knife Dissection - This is the traditional method of having your tonsils removed using a scalpel. The tonsils are completely removed and there is minimal bleeding.
- Electrocauterization - This method burns the tonsils and surrounding tissue in a way that prevents a lot of bleeding. Unfortunately this method can cause more pain during the post-operative period.
- Harmonic Scalpel (Ultrasonography) - This method uses energy from an ultrasound to vibrate the blade. This results in a clean cut that also cauterizes the tissue. This method allegedly causes less damage to the tissue than electrocauterization.
- Radiofrequency Ablation - This procedure can actually be performed in a doctor's office under sedation. It is not a one-time procedure but rather gradually shrinks the tonsils using radiation after several appointments. This procedure is only recommended for enlarged tonsils.
- Carbon Dioxide Laser - This procedure can also be performed in a doctor's office under local anesthesia and only takes about 15 minutes. Post-operative bleeding can occur the first or second post-op day. The advantage of this procedure is decreased pain and morbidity. However, this procedure is not recommended for all patients, particularly children.
- Bipolar Radiofrequency Ablation - This method must be performed in an operating room under general anesthesia. It uses a very complex method of action that disrupts the molecular bonds of the tonsilar tissue. It can be used to remove some or all of the tonsils. This method is associated with less pain and post-operative care.
- Microdebrider - This procedure is actually used for partial tonsillectomies only. The enlarged or obstructive portion of the tonsil is shaved off. This procedure carries less risk of pain after surgery.
This information is intended to give you a brief overview of different methods of removing the tonsils. There are risks and benefits to each of these methods. You will need to discuss which method is right for you with your surgeon.
Please see page two for more information on after-care.