What Is a Tonsillectomy?
A tonsillectomy is surgery to have your tonsils removed. Children who often have sore throats or who snore might have their tonsils taken out. But adults sometimes need a tonsillectomy, too. The procedure's done the same way in kids and adults, but if you're an adult, the risks and recovery can be different.
Reasons to Get a Tonsillectomy
Your tonsils are two oval clumps of tissue that sit in the back of your upper throat. If you open your mouth wide, you can see them. They usually grow to full size — a little bit bigger than a marshmallow — by the time you're an adult.
Like your lymph nodes, your tonsils are part of your immune system. They trap germs that get into your body through your mouth or nose. But sometimes, they can get swollen or become infected. If you've ever had strep throat, you probably had an infection in your tonsils. That can cause breathing problems or sore throats that don't go away.
Reasons you might need to have your tonsils removed as an adult include:
- Chronic (ongoing) throat infection. This is the most common reason. Adults who have a tonsillectomy usually have had several sore throats over 1 to 3 years or have had a sore throat and swollen tonsils caused by infection for at least 3 months. Your sore throat might get better with antibiotics, then come back as soon as you're done with the treatment.
- Obstructive sleep apnea. Enlarged tonsils can cause a blockage of your upper airway. That can cause you to stop breathing when you sleep.
- An abscess. A collection of pus and debris in your tonsils area can make your breath smell bad. While antibiotics and drainage can clear it up, an abscess sometimes returns.
- Bleeding. Although it's not common, the blood vessels near your tonsils can start to bleed. A tonsillectomy could stop this from happening again.
- Cancer. If a tumor is found in one or both of your tonsils, a tonsillectomy may be part of your treatment plan.
Research shows that if you're a woman or assigned female at birth (AFAB), you're more likely to have a tonsillectomy. One study shows that you're twice as likely to have the procedure as men or someone who is assigned male at birth (AMAB).
How Do I Get Ready?
Before your tonsillectomy, your doctor will want to know about any medicines or supplements you take. This includes over-the-counter medications, such as aspirin, as well as any herbs and vitamins.
Your doctor may tell you to stop taking certain medicines or supplements. For example, 2 weeks before surgery, you won’t be able to take:
- Aspirin or any medicines that have aspirin
- Ginkgo biloba
- St. John’s wort
Your doctor will also ask about:
- Your reactions or allergies to medicines
- Side effects that you or your family members have had with drugs used for anesthesia
- Bleeding disorders that you or your family members have, such as issues with blood clotting
Before your tonsillectomy, your doctor will likely ask you to have some tests. Blood tests can provide more information about your general health. A sleep study, or polysomnography, is a painless test that monitors your sleep stages and cycles. If you need a tonsillectomy because you have obstructive sleep apnea, your doctor could review your sleep study results first.
Starting at midnight the night before the surgery, you won’t be able to eat anything. You may be able to have some liquids, but check with your doctor to see what’s allowed.
Adult Tonsillectomy Procedure
You'll be given general anesthesia, so you'll be unconscious and pain-free during the surgery. Some people react to the drugs or gasses used for this. That’s why your doctor will ask you lots of questions about your medical history ahead of time.
Your surgeon could gently use a traditional scalpel to take out your tonsils. Or they could use a different tool or technique, like:
Harmonic scalpel: This device uses ultrasonic vibrations to free your tonsils, then close the wound to control bleeding.
Electrocautery: A special tool carefully heats and destroys your tonsil tissue.
Coblation tonsillectomy: A radiofrequency device called a coblator operates at a lower temperature than some other surgery tools and uses saline solution to cool the back of your throat. This may help protect against tissue damage and could speed up your recovery time.
Snare tonsillectomy: Your surgeon could also opt to use a surgery tool with a very thin loop. Known as a snare, it can clamp off the surgical site so it doesn't bleed too much.
How long does a tonsillectomy take?
A tonsillectomy takes about 30 to 45 minutes. It's usually an outpatient procedure, which means you should be able to go home the same day. Although it's not common, your surgeon may want you to stay in the hospital overnight. For instance, this might happen if there's a complication with your surgery or you have a medical condition that requires some extra care.
Right After Your Tonsillectomy
Right after surgery, your health care team will watch your vital signs, such as your heart rate and breathing. As you wake up, you might feel sick to your stomach. That’s part of the anesthesia wearing off and is common. If you're doing well after a few hours, you'll likely be sent home to recover. But if you have a lot of bleeding, bad vomiting, trouble breathing, or other issues, you'll probably stay in the hospital overnight.
After a tonsillectomy, you could notice:
- Pain in your ears, neck, or jaw
- Pain in your throat
- Bad breath
- A mild fever for a few days
- Nausea or vomiting
- Swelling in your throat or tongue
- A feeling like something is stuck in your throat
- Temporary loss of taste
- Food or drink coming out of your nose. This can last a few days or a few weeks.
Your voice may also sound more nasal for a while.
Risks of Tonsil Removal in Adults
A tonsillectomy is considered safe for adults. But all surgery comes with risks. These can include:
- Infection. This is rare, but it’s a small risk with any surgery.
- Pain
- Dehydration (not having enough fluid in your body)
- Side effects from the anesthesia
- Issues with your throat healing
Bleeding after tonsillectomy
About 5 out of every 100 adults who have their tonsils taken out have bleeding afterwards. If so, it usually begins the week after your tonsillectomy, although it could also not happen until a month later. The most common signs are:
- Feeling like you're swallowing more than usual
- Blood in your saliva (spit)
- Throwing up and noticing blood in your vomit
Treat any bright right blood that you see like an emergency. You might be losing a lot of blood and don't realize it. If you have any of the above signs, get to a hospital right away.
Tonsillectomy Recovery
You might need around 2 weeks to recover from a tonsillectomy.. To help you feel better, try to:
- Take your pain medication as prescribed. The pain will be worse right after surgery, but it should start to go away after the first week. Your doctor will let you know which medicines you can take for relief. Let them know if your pain gets worse instead of better.
- Suck on ice cubes or ice pops to help with throat pain.
- Drink plenty of water to stay hydrated.
- Skip hot showers or very warm baths at first. These may raise your risk of bleeding.
- Don't try to do too much too soon. Get plenty of rest, especially the first few days after your tonsillectomy. This will help your body recover and reduce your chances of bleeding.
- Stay away from intense activity for 2 weeks after your tonsillectomy. Avoid working out and carrying heavy objects.
Generally, you’re ready to get back to your usual routine when you can eat and drink as usual, when you sleep through the night, and when you don’t need medicine for pain. Check with your doctor if you have any questions.
What to eat after tonsillectomy
Try easy-to-swallow, bland foods after surgery.Cold or cooled foods will feel best on your throat.
Some options include:
- Applesauce
- Yogurt
- Smoothies
- Ice cream
- Pudding
- Mashed potatoes
- Broth
Skip hard, spicy, or crunchy foods until your doctor says it's OK. These types of foods may irritate your throat. So can acidic foods like citrus fruits.
Tonsillectomy scabs
As you recover, you'll notice that scabs form where your tonsils were removed. This is normal. Once the area heals in 5 to 10 days, the scabs will come off. You may notice some slight bleeding when they do.
When Should I Call the Doctor?
Symptoms such as pain, snoring, and fever under 102 F can happen after a tonsillectomy. But call your doctor if you notice:
- You don't have to pee often, and you feel weak, dizzy, lightheaded, or have a headache. This could mean you haven’t had enough fluids and are dehydrated.
- You have a fever 102 F or higher. It may be a sign of infection.
- You throw up or still feel sick to your stomach more than 12 hours after surgery.
Go to the emergency room if you have:
- Trouble breathing
- Any bleeding. Small specks of dark blood in your nose or spit are normal after a tonsillectomy, but bright red blood means you need to see a doctor.
Will My Tonsil Problem Return?
Most adults who have their tonsils taken out because of chronic infection say they:
- Have fewer sore throats
- Don't have to use antibiotics as often
- Miss fewer days at work
- Have fewer doctor's visits
- Have better general health
Tonsillectomy Cost
It's difficult to predict how much you'll pay for a tonsillectomy if you live in the U.S. The cost depends on many factors, including:
- Whether or not you have health insurance, and the type of plan you have
- The surgeon's fees
- Whether the medical center/hospital is covered by your health plan
- If you have complications that require a hospital stay or other care
If your doctor thinks you need your tonsils out, get an estimate from their billing office. If you have health insurance, call the number on the back of your card to confirm that your surgeon and medical center are in network. This means that they have a contract with your health plan and you'll pay a lower rate than if your tonsillectomy is done by a surgeon or at a medical center that's out of network.
Your health plan representative can also estimate how much you'll pay for the procedure. Ask them to email or mail you this information in case any issues come up later.
If you don't have insurance, call your local Medicaid office to see if you qualify for coverage. You can also ask your doctor about a charity care discount and/or a payment plan.
Takeaways
A tonsillectomy is sometimes needed to treat an ongoing issue like repeated throat infections or obstructive sleep apnea. Follow your doctor's advice before and after the surgery. This will lower the chances that you have complications, like bleeding, and get you feeling better as quickly as possible.
