The palatine tonsils are commonly known as "tonsils." Tonsillectomy is literally a surgery to remove the palatine tonsils. Tonsillitis, which causes swelling in the throat, is a common illness among children, but if it occurs several times a year or becomes severe, it may be necessary to have the tonsils removed surgically. In recent years, it has become common not to remove the tonsils unnecessarily, and the number of Tonsillectomy procedures has decreased. However, if a Tonsillectomy is done properly, the unpleasant symptoms will go away. How should you decide whether or not to have surgery? We will explain this under the supervision of a pediatrician.

What are the tonsils, and what are they for?

The palatine tonsils (tonsils) are tissues that control the immune system and contain immune cells that fight pathogens that enter through the mouth and nose. In addition to the palatine tonsils, the adenoids (pharyngeal tonsils), Eustachian tube tonsils, and lingual tonsils are arranged in a ring around the nose and throat.

When is it better to have surgery?

If recurring tonsillitis is affecting other organs or if the inflammation is severe, surgery may be considered. For example, surgery may be recommended in the following cases. When bacteria that have settled in the tonsils cause illnesses other than tonsillitis:

When bacteria that have settled in the tonsils cause illness in parts of the body away from the tonsils, it's called a focal tonsillar infection (focal tonsillitis). Common illnesses include skin diseases (palmoplantar pustulosis, psoriasis vulgaris, etc.), kidney diseases (acute glomerulonephritis, IgA nephropathy), and bone and joint diseases (rheumatoid arthritis, etc.).

If enlarged tonsils make it difficult to breathe or eat

Surgery is recommended, especially if you have sleep apnea, a condition in which breathing stops for periods of time while you sleep.

Peritonsillar Abscess

Inflammation of the palatine tonsils and the surrounding area is called peritonsillitis. If the inflammation continues and pus accumulates on or around the tonsils, it is called a peritonsillar abscess. If pus accumulates, surgery is required. If the pus leaks into the neck or chest, it can become a life-threatening condition. To remove the pus, the tonsils are removed by suction or incision.

Why do tonsils become enlarged?

As children grow, they need to acquire resistance to various pathogens. For this reason, tonsillar tissue, particularly the palatine tonsils, physiologically enlarges during childhood. If the weight of an adult's tonsils were 100%, they would grow to approximately 180% of that of an adult's tonsils at around age 12, after which they naturally shrink and reach adult size.

Therefore, unless the tonsils are inflamed, this is a physiological enlargement and does not pose a major problem. Furthermore, there is no way to stop physiological enlargement. Therefore, surgery is not necessary in most cases, but as mentioned above, surgery may be recommended if the enlarged tonsils cause severe symptoms, such as difficulty breathing or eating.

Modern Approach to Tonsillectomy

Tonsillectomy was widely performed in the past, but the number of surgeries performed has decreased recently. This is because the role of the tonsils has become clearer, and surgery is no longer performed unnecessarily. However, if surgery is necessary, we recommend that you consult with an ENT specialist West Yorkshire and wait until the time is right to have the surgery. Tonsils are organs responsible for the immune system, preventing viruses and bacteria from entering the body and causing illness. In that sense, it's best not to remove them if possible, but there are reports that there's almost no difference in immune strength between having surgery and not having surgery in children over the age of 4 or 5, so there's no need to worry too much.

Target diseases

Habitual tonsillitis (when you suffer from tonsillitis more than four times a year)

Tonsillar focal infection (IgA nephropathy, palmoplantar pustulosis, sternocosto-clavicular hyperplasia, etc. Each requires evaluation by a specialist department.

• sleep apnea syndrome

• Length of hospitalization

• The hospital stay is generally around one week. However, please note that discharge may be delayed depending on the postoperative progress, for example, if there is a high risk of bleeding.

How is the surgery performed? Are there any risks involved?

Surgery to remove the tonsils is called a tonsillectomy, and involves removing the tonsils (the bulges on the left and right sides of the back of the throat, commonly known as tonsils. More specifically, they are called palatine tonsils. This is performed by an ENT department and can only be performed on patients aged 4-5 years or older, but if the patient has sleep apnea syndrome, it may be performed on younger patients. The length of hospital stay varies depending on the hospital and the patient's symptoms, but is usually between a few days and 7-10 days. Patients will not be able to eat by mouth for a while after the surgery.

Surgical method

The procedure is performed under general anesthesia. The mouth is opened wide with a mouth retractor, and both palatine tonsils are removed using instruments such as an electric scalpel. In case of bleeding, the blood vessels are cauterized or tied off with thread to stop the bleeding. Once we have confirmed that there is no bleeding, the surgery is completed. The surgery takes approximately 1 hour.

Possible complications

Bleeding:

Bleeding that is mixed with saliva will often thin naturally. If the bleeding is strong and heavy, it may be necessary to administer general anesthesia again to stop the bleeding. This type of heavy bleeding is likely to occur immediately after surgery and one week after surgery, so we will manage it carefully.

Sore throat:

Sore throat after surgery is unavoidable. If the pain is severe, painkillers will be used as needed. The pain typically subsides over time.

Angular cheilitis/stomatitis

Because the mouth is opened wide with the mouth gag, the corners of the mouth may be torn. Additionally, prolonged use of the mouth gag may cause mouth ulcers to develop or make the tongue feel uncomfortable. In most cases, these symptoms will improve over time.

After discharge

Approximately 1-2 weeks after you are discharged, so we recommend that you continue to rest after being discharged. You can return to desk work, but you should avoid heavy labor such as carrying heavy loads or moving your body. If you still have even the slightest pain, avoid hot, spicy, or hard foods and eat foods that are easy to eat. In most cases, the pain will subside by the time you are discharged from the hospital, and you will be able to eat without any problems, but you may experience bleeding, an unpleasant feeling in your throat, taste disorders, changes in your voice, etc. It is a good idea to discuss the procedure thoroughly with the Best ENT surgeon before undergoing surgery, and be sure to be satisfied with the results before undergoing surgery.