About tonsil operations

Are there any risks involved with the operation?

There’s always a risk involved with surgery and when an anesthetic is used, but it’s minor and all care is taken to make sure that the operation is as safe as possible. A few patients do unfortunately experience bleeding after having their tonsils removed. This bleeding most often stops by itself. Sometimes, the patient may need to return to the operating room in order to have the bleeding stopped under anesthetic.

The throat should never bleed once you’ve arrived home after the operation. If you notice any bleeding, you must contact health care services immediately.

There are wounds where the tonsils used to be and on these wounds grey-white layers form, that are the mucous membrane’s equivalent of scabs on the skin and a sign of healing. These layers can smell bad and can cause bad breath. The layers start to disappear after approximately 7-10 days. The risk of bleeding exists up until the wounds are fully healed, which can take up to three weeks. You may have a slight fever the first day, but this is quite normal. If you’re affected by the fever, you should contact the health care services.

If you find that the painkillers aren’t sufficient and that you’re having difficulty drinking enough liquid, you should contact the health care services.

When is tonsil surgery needed due to enlarged tonsils?

The tonsils are located on either side of the throat. Enlarged tonsils can cause discomfort during sleep. The disruption to sleep, in this context, involves snoring and mouth breathing simultaneously and sometimes interrupted breathing (apnoea) or snoring in combination with waking-up frequently and restless sleep. Night sweats and abnormal sleeping positions, such as with the neck bent backwards, occur often and a number of children wet their beds at night. Such sleep disorders causing reduced sleep quality, in turn, affect life during the part of the day we are awake in various ways, e.g. in the form of excessive daytime sleepiness, deviance, such as mood swings, hyperactivity, asthenia, attention and concentration problems or increased oppositional defiant disorder symptoms and aggressive behavior symptoms. All of this, in turn, has an impact on the quality of life of children and young people.

Enlarged tonsils can also affect the ability to speak, chew and swallow. If the throat feels tight, it can lead to problems eating particularly chewy food, it can make having to swallow small amounts necessary and it can mean that mealtimes take much longer than normal. This, in turn, can cause problems when it comes to maintaining a normal weight in relation to age. Children with enlarged tonsils most often breathe through an open mouth, drooling can occur and several speech functions can be affected. The speech often sounds thick and slurred. The articulation of consonant sounds made at the front of the mouth is negatively affected, as is the voice. Mouth breathing, which is caused by enlarged tonsils and adenoids (the glands behind the nose) can negatively affect the maxillofacial development of small children.

When is tonsil surgery needed due to throat infections?

Tonsillitis is a tonsil infection caused by bacteria or viruses. The tonsils become red, swollen, it hurts when swallowing and, in most cases, there is fever. Headaches, aches up towards the ears and stomach aches are also common. If you experience frequent relapses of tonsillitis, it can affect your daily activities causing a reduced quality of life. In the event of considerable discomfort as a result of repeated episodes of tonsillitis despite adequate treatment (3-4 relapses over the course of a year), a tonsil operation may be considered.

What is the difference between operating on “the whole” or “part” of the tonsil?

Tonsil surgery can be performed in two fundamentally different ways. The whole tonsil can be removed (tonsillectomy) or the size of the tonsil can be reduced (tonsillotomy). The guidelines are that repeated tonsillitis can justify a tonsillectomy. A tonsillotomy is often performed when the tonsils are enlarged and are judged to cause obstructed breathing during sleep. A tonsillotomy causes less pain, has a lower risk of bleeding and enables a quicker return to normal activity. With a tonsillotomy, there is a small risk of the symptom-generating regrowth of the remaining part of the tonsil. The assessment of which surgical procedure is best for the child in question is made by the doctor who will perform the operation.

Tonsiller före operation
What tonsils look like pre-surgery.
What they look like post surgery in the case of a total tonsillectomy.
What they look like post surgery in the case of removing protruding parts of the tonsils. This results in less pain and less haemorrhaging than in the case of a total tonsillectomy.

When are the adenoids behind the nose operated on?

In those cases where children are operated on because their tonsils are enlarged, the size of their adenoids (the glands behind the nose) is also assessed. If the adenoids are enlarged, then they are also removed. This operation doesn’t cause the child too much extra discomfort.