Tonsil and Adenoids Surgery

Tonsils and adenoids are called lymphoid cells. It has a role in lymphocyte production. They are small due to immunoglobulins (antibodies) passing through the mother in the newborn. It begins to shrink after the 4-6 age range of applications at its maximum size, and then came the age of 12 are expected to disappear completely.

If the nasal flesh is larger than normal, it may cause nasal obstruction, but may also be the cause of middle ear effusions. If, a larger than normal nasal flesh; hearing loss, snoring, mouth breathing, mouth open sleep, dry mouth, especially night-time coughs, can cause runny nose. Continuous nasal obstruction and mouth breathing due to the size of the nasal flesh; orthodontic disorders, facial development disorders and speech disorders.

Tonsil growth (tonsil hypertrophy), narrowing the airway with the effect of a mass occupying the throat, snoring, inability to breathe easily, sleep breathing (apnea) may be the cause of problems.

When tonsil and nasal flesh growth reaches a size that narrows the upper respiratory tract, it causes serious problems such as snoring and apnea. In these cases, it is useful to consult a ENT specialist as soon as possible.

The disease known as rheumatic fever is a complication caused by antibodies against group A beta hemolytic streptococci. It can lead to disorders of the heart valves, which may occur as a result of the body's self-attack (produced by antibodies) in people with frequent tonsillitis.


Tonsils and adenoids should be taken in what circumstances?

Tonsil and adenoid surgery is one of the most frequently performed surgery in the ENT clinic. There are two main topics used to decide this surgery.


Conditions requiring definitive surgery:

  • Clogging of the upper respiratory tract due to tonsil and nasal flesh (snoring and sleep breathing)
  • Suspected malignant tumor
  • Asymmetric tonsil (one tonsil is larger than the other)
  • Nutritional and speech-impaired tonsil size
  • Developmental problems in teeth and face


Conditions requiring relative surgery:

  • Frequent recurrent tonsillitis (7 times in the last year or 5 times per year in the last two years or 3 times per year or more frequent inflammation of the tonsils in the last three years) 
  • Chronic tonsillitis (chronic tonsillitis)
  • Carriers of diphtheria
  • People with heart valve disorder.
  • Frequent middle ear inflammation due to tonsillitis and nasal inflammation.
  • Bad Breath
  • Peritonsillar abscess (abscess formation around the tonsil tissue)
  • Tonsil tuberculosis (tonsil tuberculosis)


(Most of the tonsil surgeries are performed for this reason.)


This surgery is done at what age?

Although tonsil diseases are known as a pediatric age group problem, the above mentioned rules apply in adults. Tonsil surgery is also performed in adults who do not have any serious health problems to prevent the operation. The lower age limit is 3 years except for compulsory cases. It is not possible to determine the upper age limit. In general, the incidence of this disease is low in older ages and simple solutions are often preferred.


Is tonsil surgery risky?

Tonsil surgery is fairly low risk. Statistics reported in one in 14,000 surgeries are serious complications due to anesthesia or surgery. Postoperative serious bleeding rate is as low as 5/1000. After the tonsil surgery, many scientific studies have been done about the body's defense system, but no clear results have been obtained. A reduction in the number of certain types of lymphocytes has been shown in humans with tonsils removed. However, this was not found to cause clinical problems. There is a belief that pharyngitis is easier after tonsil surgery. The incidence of pharyngitis is the same in people with or without tonsils. Taking tonsils does not increase the rate of pharyngitis.


Does the preferred surgical technique matter?

The choice of operation technique is entirely related to the experience of your physician. Each technique has its own advantages and disadvantages. For this reason, your doctor will choose which technique he / she feels safe with.


In my personal practice, I prefer cold surgical dissection because of the low risk of postoperative pain and bleeding. I do not use cautery in the mouth (thermal welding or bipolar cautery) either because it increases postoperative pain or because I think there is a high risk of bleeding in the late period.


How long is the recovery period after surgery?

Although it varies from person to person, as a general rule, it is more comfortable in children after surgery. In about 5-7 days, pediatric patients begin to eat normal food, while in adult patients this period can sometimes take 10-12 days. During this period, if you are not working in a job that requires you to talk too much, you can return to work on the 3rd postoperative day.


How should I eat after surgery?

In the early post-operative period, you come to your room from the operating room approximately 4 hours after, you start eating by simple ice cream. Ice cream blood and reduce your pain is an important choice in terms of reducing the risk. After your discharge, our service nurses will give you a detailed diet list for each day.


When can I be discharged after surgery?

If we do not encounter any problems after surgery, we can discharge the child patients on the same day and adult patients on the following day. As I mentioned before, we prefer to keep adult patients under observation with painkiller as the postoperative, for pain of adult patients is a bit higher than that of child patients.


Can there be postoperative bleeding? If yes, what should I do?

Whichever surgical technique is preferred, there is always a low risk of bleeding (0-6%) after the operation. The first 48 hours after surgery is the most important period in terms of bleeding. In this period, bleeding control can be made by spitting on the napkin without scraping the throat. If pink or red blood is seen, call your doctor as soon as possible.

In case of bleeding, after informing your doctor without panic, apply to the emergency department of the hospital nearest you (Firstly, if the hospital where you have surgery is close to you, you should prefer it.) Bleeding may require a second operation or can be controlled by local intervention.

What is important here; in case of detection of postoperative bleeding; don’t panic and to manage the crisis period in cold-blooded connection with your doctor.