Mr John Marshall - Consultant Otolaryngologist

Tonsillitis

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(Tonsillitis and Tonsillectomy)

Recurring tonsil infections can be very debilitating. Mild or infrequent episodes can be treated by your simple analgesia, and with antibiotics if your doctor feels they are required.

Not everyone who gets tonsillitis needs their tonsils removed, but if infections are occurring repeatedly, for a prolonged period and are disrupting your normal functioning, an operation to remove the tonsils (tonsillectomy) should be considered.

In Scotland, guidelines are published* to advise how much trouble makes tonsillectomy worthwhile. In summary if you are having 3 bad episodes of tonsillitis a year for three or more years, tonsillectomy should be considered (equally, 5 episodes per year for two years or a single year with seven episodes make tonsillectomy worthwhile).

Other problems such as very large tonsils contributing to very loud snoring (link) or sleep apnoea syndrome (link), or troublesome ‘tonsil stones’ (debris getting trapped in the tonsils causing pain and halitosis) sometimes merit consideration of tonsillectomy.

Tonsillectomy can be performed as day surgery or with a single night stay in hospital. .

Whilst your tonsils should in theory be helping your immune system, there is no evidence that removing tonsils causes any problem with the immune system. In contrast, the negative effects on your health from repeated tonsillitis are obvious to anyone who suffers from this condition.

Pros and Cons

Tonsillectomy is a very good operation at sorting out the problem of recurring sore throats due to tonsillitis.

There is a small risk of bleeding for the first 2 weeks after tonsillectomy, especially between days 5 and 10. Usually any bleeding is mild and needs no active treatment but may involve coming back into hospital. There is a 1-2% risk of more significant bleeding that may require a blood transfusion or a second operation.

After the operation you can get a pretty bad sore throat for the first week or so, and this can take 2-3 weeks to completely settle. You will be given two different strong painkillers to help.

Very rarely tonsil-like tissue may re-appear and cause further infections and very occasionally these may need to removed at a later date.

* SIGN Guidelines weblink - http://www.sign.ac.uk/guidelines/fulltext/117/index.html

 

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