Tonsillectomy

Tonsillectomy
This is one of the most commonly performed operations. Patients usually stay in hospital for one night, so that bleeding may be recognized and treated appropriately. Tonsils are removed by dissection under general anaesthetic. Haemostasis is achieved with diathermy or ties.

Tonsillectomy is very painful and regular simple analgesia is always required afterwards. Patients should be advised that referred pain to the ear is common. Until the tonsillar fossae are completely healed, eating is very uncomfortable. The traditional jelly and ice cream has now been replaced with crisps, biscuits, and toast, since chewing and swallowing after tonsillectomy is very important for recovery and in helping to prevent infection.
In the immediate postoperative period the tonsillar fossae become coated with a white exudate, which can be mistaken as a sign of infection.

Indications for tonsillectomy
1- Absolute indications for surgery
• Suspected malignancy
• Children with OSA (obstructive sleep apnoea)
• As part of another procedure such as UPP for snoring.
2- Relative indications for surgery
• Recurrent acute tonsillitis
• 3 attacks per year for 3 years or
• 5 attacks in any one year
• More than one quinsy.
Big tonsils which are asymptomatic need not be removed.