The American Academy of Otolaryngology advises tonsillectomy for patients having three sore throats a year for three years in a row, five sore throats a year for two years in a row, or seven sore throats in a single year. Basically, it comes down to whether the patient would rather deal with recurrent infections or having a tonsillectomy.
Patients with a recurrent peritonsillar abscess should get their tonsils removed because of the likelihood of continued recurrence. We often recommend just taking the tonsils immediately to combine the current sore throat with the resulting post-surgical sore throat, allowing the patient to be cured under a general anesthetic.
When we perform a tonsillectomy, we almost always address the adenoid. If there is any significant adenoid tissue, we will also remove it. This adds very little risk or postoperative pain, and avoids the possibility of having to perform another surgery in the future.
When the patient arrives at the hospital or surgery center, the anesthesiologist or nursing staff may meet with the patient and family to review the patient’s history. The patient will then be taken to the operating room and given an anesthetic via a breathing mask. After the child is asleep, an IV is started and fluids are usually given during and after surgery.
The surgery itself is carefully performed through the mouth. In our office, we have tried several new technologies from Laser to Harmonic Ultrasound Scalpel, but have found no benefits. We always continue to consider the latest technology to better treat our patients. We feel that currently, electro dissection or coblation technology works best. Patients rarely lose any blood recover in about the same time period regardless of the surgical method used.
After the operation, the patient is taken to the recovery area. Recovery room staff will observe the patient until discharged. Every patient is special, and recovery times vary for each individual. Many patients are released after two to ten hours. Others are kept overnight. Intensive care may be needed for select rare cases.
We do everything we have ever heard about, read about, or thought about to make the experience more tolerable, including:
- Treating the tissues as delicately as possible with the surgical instruments
- Administering I.V. steroids and antibiotics to lessen inflammation
- Inject the tissue surrounding the surgery with a long acting anesthetic (Marcaine) to numb it
- Provide post-operative pain medicines and antibiotics to reduce pain and bad breath
- Technologies used for tonsillectomies