At a glance
- Reasons
- Recurrent tonsillitis, large obstructive tonsils, snoring and apnoea in children.
- Techniques
- Tonsillectomy, radiofrequency or laser tonsillotomy, adenoidectomy.
- Anaesthesia
- General.
- Hospital stay
- Adenoidectomy and tonsillotomy are day surgery. Tonsillectomy, day surgery or one night.
- Recovery
- About a week; adults usually take around 7 days off work after a tonsillectomy.
What are tonsils and adenoids?
The tonsils are two pads of lymphatic tissue at the sides of the throat. The adenoids are similar tissue behind the nose, which cannot be seen by opening the mouth. Both play a defensive role in childhood, but when they become infected very often or grow too large, they cause more problems than they solve.
When surgery is recommended
In adults:
- Recurrent tonsillitis needing antibiotics and time off work several times a year.
- A previous peritonsillar abscess (quinsy).
- Large tonsils contributing to snoring or sleep apnoea.
- Tonsil stones and persistent bad breath not helped by other measures.
- An asymmetrical tonsil that needs investigating.
In children:
- Snoring, breathing pauses or restless sleep caused by large tonsils or adenoids.
- Mouth breathing and a nasal-sounding voice.
- Glue ear or recurrent ear infections linked to the adenoids.
- Recurrent tonsillitis.
Diagnosis
We examine the throat, nose and ears. A fine nasal endoscope shows the adenoids without X-rays. If sleep apnoea is suspected, a sleep study is added. With children, the examination is calm and adapted to their age.
Techniques
- Tonsillectomy: complete removal of the tonsils, mainly for recurrent infections.
- Radiofrequency or laser tonsillotomy: partial reduction when size is the problem. Less pain and a quicker recovery. It is day surgery.
- Adenoidectomy: removal of the adenoids through the mouth, with no external cuts. It is day surgery, can be done with radiofrequency and can be combined with ventilation tubes (grommets) if there is glue ear.
Recovery
- Children: usually back to almost normal life within a week. Soft, cool food, plenty of fluids and regular pain relief.
- Adults: painful swallowing is usually worse than in children and is sometimes felt in the ear. As a guide, adults take around 7 days off work after a tonsillectomy.
- Warning sign: any bleeding from the mouth in the first 15 days means you should contact us or go to A&E.
Risks
The most important is bleeding after the operation: uncommon, but you need to know about it. Others include pain, temporary changes in taste or voice, and partial regrowth of tissue after a tonsillotomy. We will go through everything with you before you decide.
Frequently asked questions
How many bouts of tonsillitis justify surgery?
As a guide, clinical guidelines consider surgery after about 7 well-documented episodes in one year, 5 a year for two years or 3 a year for three years. It is also considered after a peritonsillar abscess (quinsy) or when large tonsils block breathing.
What is the difference between tonsillectomy and tonsillotomy?
Tonsillectomy removes the whole tonsil. Tonsillotomy reduces its size, leaving a layer of tissue, and is used mainly when the problem is obstruction. It is usually less painful, with a quicker recovery.
Will I miss my tonsils or adenoids?
Not in daily life. The immune system has plenty of other lymphatic tissue that does the same job.
Is the operation more painful for adults?
Yes, recovery is generally longer and more uncomfortable for adults than for children. That is why a good pain-relief plan and the right diet in the first days are important.
My child snores and breathes through the mouth. Should I worry?
Enlarged adenoids and tonsils are the most common cause of snoring and sleep apnoea in children, and can affect sleep, growth, school performance and even facial and dental development. It is worth having it assessed.
How long should we stay in Barcelona after surgery?
Because of the small risk of bleeding in the first two weeks, we recommend staying nearby for the first days and avoiding long-haul flights until we have checked the throat. We will plan the dates with you in advance.
You may also be interested in
- Snoring and sleep apnoea surgery
- Ventilation tubes (grommets)
- Septoplasty and functional rhinoseptoplasty
- Second opinion before ENT surgery
- International patients
Before surgery you receive the informed consent document of the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC), which explains the technique, its alternatives and its risks.
Guidance written by the team of Dr. Carlos Magriñá, an ENT surgeon with more than 35 years of experience in Barcelona. Every case needs an individual medical assessment.