What is a tonsillectomy?

A tonsillectomy is the surgical removal of the tonsils. The tonsils are visible glands located in the back of your throat. Tonsils fight infection but can get infected and enlarged themselves. Infection of the tonsils is called tonsillitis. Frequent bouts of tonsillitis can lead to difficulty breathing, sleep apnea (pauses in breathing during sleep), difficulty eating, and ear infections. Your doctor may recommend a tonsillectomy if you or your child suffer from any or all of these conditions. 

Tonsillitis is most likely to occur in children because the tonsils are larger in children, but it can occur in adults as well. A common cause of tonsillitis is a bacterial infection of Streptococcus pyogenes, commonly known as strep throat. Certain viral infections, such as cytomegalovirus and adenovirus infections can also lead to tonsillitis.

A tonsillectomy is a common but major surgery with serious risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before you or your child has a tonsillectomy. 

Other procedures that may be performed

Your doctor may recommend removal of your adenoids along with a tonsillectomy. The adenoids are also infection-fighting glands located in the throat. Adenoids can get infected and enlarged along with the tonsils and cause similar problems. 

Why is a tonsillectomy performed?

Your doctor may recommend a tonsillectomy to treat a child or adult with problems related to the tonsils. These include: 

  • Antibiotic treatment failure, in which antibiotics do not cure a bacterial tonsil infection
  • Cancer of the tonsils
  • Difficulty eating or swallowing due to enlarged tonsils
  • Excessive and loud snoring due to enlarged tonsils that block the breathing passages
  • Frequent bouts of tonsillitis, in particular more than four tonsil infections over a year or five to seven over a two year period
  • Sleep apnea, or pauses in breathing during sleep caused by enlarged tonsils
  • Tonsillar abscess that does not respond to drug treatment

Your doctor may only consider tonsillectomy if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on a tonsillectomy.

Who performs a tonsillectomy?

The following specialists perform tonsillectomy:

  • Otolaryngologists (ENTs) specialize in the treatment of diseases and conditions of the ears, nose and throat. 
  • Pediatric otolaryngologists (pediatric ENTs) specialize in the treatment of diseases and conditions of the ears, nose and throat in infants, children and adolescents.
  • Pediatric surgeons specialize in surgery for infants, children and adolescents.

How is a tonsillectomy performed?

Your tonsillectomy will be performed in a hospital or possibly an office or clinic setting. The surgery is generally an outpatient procedure. Some patients may need to stay overnight in the hospital for observation. 

Surgical approaches to a tonsillectomy

Your surgeon will remove or reduce the size of your tonsils through your mouth. Your surgeon will most likely remove all of your tonsil tissue if you have repeated tonsillitis. Surgeons sometimes only reduce the size of tonsils if they are enlarged. 

Your surgeon will advise you on which procedure is best for you based on your diagnosis, age, medical history, general health, and possibly your personal preference.  Learn about the different procedures and ask why your surgeon will use a particular type for you.

The types of tonsillectomy approaches include:

  • Electrocautery burns off tonsil tissue. It also helps reduce blood loss by cauterization, which seals the blood vessels. 
  • Harmonic scalpel uses hot ultrasonic energy to vibrate a special blade. The blade cuts tonsil tissues and stops bleeding. 
  • Laser tonsil ablation (LTA) uses a laser to destroy and remove tonsil tissue. 
  • Microdebrider reduces the size of the tonsil with a rotary shaving device hooked up to suction. 
  • Radiofrequency ablation (somnoplasty and coblation) procedures use radiofrequency energy to destroy tonsil tissue. 
  • Scalpel removal of the tonsils is the most traditional tonsillectomy procedure.