Tonsillectomy

This is the medical name for surgical removal of the tonsils. This is done in cases where someone has repeated bouts of tonsillitis or has a severe form of tonsillitis which is affecting their quality of life.

Tonsillectomy is one of the popular forms of surgery undertaken on children.

At one time tonsillectomy was performed on a regular basis. If someone had a bout of tonsillitis or a few episodes they would automatically have their tonsils removed.

With children the adenoids would be removed as well.

The removal of both the tonsils and adenoids was standard procedure but things have changed and this procedure is less commonly performed than before.

Reasons for tonsillectomy

There are certain situations in which a tonsillectomy is performed which are:

• Abnormally large tonsils
• Sleep apnoea due to enlarged tonsils
• Acute tonsillitis (repeated infections)
• Chronic tonsillitis with severe throat pain
• Peritonsillar abscess
• Tonsil stones in the back of the throat
• Difficulty with swallowing due to enlarged tonsils

How is tonsillectomy performed?

A tonsillectomy is performed under a general anaesthetic. Your mouth is kept open to enable the surgeon to access the tonsils and remove them. No incisions will be made in your skin.

There are a variety of ways to remove the tonsils which include:

• Surgical blade surgery
• Diathermy
• Cold ablation
• Ultrasound
• Lasers
• Freezing

Surgical blade surgery

This is the most common type of tonsillectomy. It involves the surgeon using a scalpel to dissect the tonsils from the throat. A device called a ‘snare’ is put over the tonsils and tightened which prevents any bleeding. This is kept in place until the tonsils have been removed.

In some cases the remaining blood vessel are sealed using diathermy which cauterises the wound.

This is also known as ‘cold steel’ surgery.

Diathermy

This involves the use of a probe called a ‘diatherm’ which emits heat from an electric current. This probe both destroys tissue around the tonsils which enables them to be removed, and seals the blood vessels to stop any bleeding.

Cold ablation

Cold ablation works in a very similar way to diathermy in that it uses a probe to cut through tissues to allow removal of the tonsils. The difference here is that it does this at a lower temperature than diathermy.

Ultrasound

Ultrasound involves using an ultrasonic scalpel which emits high energy waves to cut through the tissue around the tonsils which enables them to be removed. Any bleeding is stopped at the same time. This is a newer type of surgical procedure to remove the tonsils.

Lasers

Lasers are another, new option to remove the tonsils. They are used to burn through tissue, which allows the tonsils to be removed, and seal off the wound at the same time. A laser also prevents any bleeding.

Freezing

Also known as ‘cryo-tonsillectomy’: it uses very cold temperatures to remove the tonsils. A cold substance or device is used to repeatedly freeze and thaw out the tonsils before removing them. This cold temperature has the advantage of minimising the bleeding.

This is another new tonsillectomy procedure.

Freezing, ultrasound and lasers are all new forms of tonsillectomy and are not as widely available as the traditional methods such as cold steel surgery.

Your surgeon will discuss these options with you with the aim of choosing a suitable procedure for you (or your child).