
Tonsils: What happens when they are removed?
You often see your tonsils at the back of your throat, but may care little about them. Did you know that these two lymphatic glands play a vital role in keeping your body healthy? That’s right. The tonsils, while they appear soft and fragile, help the immune system in fighting infections. However, they may not always function at their best, which leads to inflammation and infections. When this happens, it is important that you seek a consultation with an ENT surgeon in Singapore as severe tonsillitis (https://drsomaent.com/conditions/tonsilitis-treatment-in-singapore/) may warrant tonsillectomy– a procedure where your tonsils are removed.
Tonsillitis: What is this condition?
Tonsillitis is an infection that affects the tonsils and may either be caused by a virus or bacteria. The tonsils stand to protect the body at the forefront as the glands fight the pathogens that enter through the nose or mouth. Bacteria and viruses get trapped by the tonsils to avoid them from reaching inside the body. Sometimes, these lymphatic glands get overwhelmed by the amount and potency of the germs that they end up swelling and infecting.
Below are the common causes of tonsillitis:
- Bacteria: Bacterial infections happen when a certain kind of bacteria called group A Streptococcus affects the tonsils. This bacteria causes strep throat. Without proper treatment, strep throat can worsen quickly, which will need a treatment of antibiotics. Bacterial infections can lead to complications that may have an effect on the other parts of the body, such as the sinus and heart. Hence, it is crucial that this type of tonsillitis is managed and treated by an ENT surgeon.
- Virus: Viral infections are the usual causes of tonsillitis. The well-known causes are common cold virus, influenza (flu), and mononucleosis (Mono). More recently, COVID-19 is also classified as a virus that can lead to tonsillitis. While tonsillitis caused by viruses tends to go away on their own, your tonsils will feel swollen and uncomfortable all throughout the stage of infection.
- Other causes: Tonsillitis may also be due to other factors, such as an autoimmune disorder, pollution or smoke that irritate the tonsils when inhaled, or fungal infections.
The common symptoms of tonsillitis are:
- Bad breath: The buildup of pus around the tonsils as a result of the infection can cause your breath to smell bad.
- Challenges with swallowing: An inflamed tonsils can be painful and make swallowing food or beverages difficult.
- Fatigue: Body aches, fatigue, and weakness can be felt by the body when there is an infection present.
- Fever: Burning with fever is usually a sign that the tonsils are infected by bacteria.
- Sore throat: The top indication that an individual is suffering from tonsillitis is sore throat. This can range from mild to severe.
- Swollen tonsils: Enlargement of the tonsils and the presence of pus patches that are either red or white in color is a sign that you have tonsillitis.
Tonsillectomy: When should you undergo surgery to remove your tonsils?
If you often have a bout with tonsillitis and the condition is usually worse, your ENT surgeon may recommend having them removed through a surgical procedure called tonsillectomy. This is the best treatment suggested for patients whose tonsillitis are chronic and do not make any improvements despite being treated using other medical approaches.
An ENT surgeon may offer tonsillectomy when the following occurs:
- Abscess formation: Severe cases of tonsillitis can result in the development of pockets filled with pus (abscess) near the tonsils. These pockets may either be drained or removed through tonsillectomy.
- Chronic tonsillitis: Having recurring tonsillitis every year can be frustrating and compromise your body’s overall health. Hence, removal of your tonsils is highly recommended.
- Sleep apnea: Tonsils that are enlarged can cause difficulty in breathing when you sleep as they block your air passage.
- Tonsil stones: Calcified deposits can build up in the pockets of the tonsils, leading to swallowing difficulties, pain, and bad breath.
Tonsillectomy: What happens during the procedure?
Tonsillectomy is considered a major surgery. During the procedure, the patient is placed under general anaesthesia. They do not feel any pain throughout the surgery as they are in deep sleep. Tonsil removal surgery often takes around 30 minutes to an hour to complete.
To carry out the surgical procedure, an ENT surgeon may opt to perform any of the following methods:
- Coblation: This is a technique that has been recently developed that uses lower temperatures of radiofrequency energy to efficiently remove the tonsils with lesser pain and quicker healing.
- Electrocautery: This surgical method is done by using high-frequency electrical currents to cut and remove the tonsils while cauterising the blood vessels simultaneously to minimise bleeding and seal them. Electrocautery is used commonly as this technique is precise, lessens the risk of bleeding excessively, and promotes faster recovery time.
- Laser surgery: This technique delivers energy-charged laser beams to vaporise the tissues of the tonsils to remove them effectively.
- Traditional surgery: The traditional method of surgically removing the tonsils is done by using a scalpel to cut through the tissues and remove the tonsils. The surgical area is closed by either cauterising or stitching it to prevent and stop bleeding.
Tonsillectomy, just like other surgical procedures, comes with possible risks and complications. These include bleeding that may occur during or post-operation, infection in the surgical area, or or a slight change in the voice after the surgery, which is rare.
Postoperative care is crucial after tonsillectomy to avoid complications after surgery. The recovery period varies per individual. If everything goes smoothly, most patients are able to recover fully between 7-10 days, while the throat heals thoroughly after 14 days or more.
Livizg a Life Without Tonsils
Knowing that the tonsils play an important role in helping the body’s immune system fight infections can be daunting for people who may have to get these glands removed. However, there is no need to worry as the body has other ways to fight and manage infections, so it is safe to say that you can still live a healthy life even without your tonsils.
For those who suffer from chronic tonsillitis, undergoing tonsillectomy may prove to be beneficial as they may experience lesser infections in the throat and better sleep, particularly for individuals diagnosed with sleep apnea caused by the tonsils.
Dr Soma Subramaniam, MBBCH (IRE), DOHNS(ENG), MMED-ORL(NUS), FRCS-ORL(ENG), Consultant ENT Specialist and Surgeon
3212 Joo Chiat Place
#05–01 Parkway East Specialist Hospital
Singapore 427990
290 Orchard Road
#09-01 Paragon Medical Centre
Singapore 238859
+65 9856 8391