Medical experts are divided about the merits of tonsillectomy and adenoidectomy.
Removal of tonsils and adenoids is less common than it used it to be. This is partly because of the potential complications but also because the reasons to have the surgery have become better defined.
Tonsillectomy will prevent recurrent tonsillitis and its complications, although no operation can stop you catching a cold, and occasional illnesses can still cause throat pain.
If enlarged tonsils or adenoids are causing a sleep disorder in a child, surgery usually improves or solves the problem. Behaviour, school performance, and quality of life may also improve.
The surgery is done under a general anaesthetic, which can be frightening for children and their parents, but it’s extremely safe.
Most tonsillectomies and adenoidectomies are problem-free. Complications are usually minor and can be successfully treated, although sometimes further surgery is needed. Complication rates vary between hospitals and surgeons (between 1.5% to 14%).
The major risks are:
- Bleeding. 2-4% of patients experience noticeable bleeding, most often between 5 and 10 days after the surgery, when the scab on the healing tissue starts to come off. Bleeding generally stops by itself but if it happens you’ll probably be readmitted to hospital for observation for 24 hours. Occasionally patients need to have additional surgery to control the bleeding, which means another general anaesthetic.
- Infection. The healing areas at the back of your throat will be covered in a whitish layer for two weeks after surgery; this is part of the healing process. Occasionally this layer can get infected, and if so you might notice worsening pain, a bad taste or smell in the throat, and/or a raised temperature. If you have any concerns contact your doctor or the hospital.
- Dehydration. Occasionally, the pain will be so severe after surgery that it prevents you from drinking enough liquid and you become dehydrated. If this happens, you may need to be readmitted to the hospital overnight for intravenous fluids.
- Bad smell in the mouth or nose. This tends to occur if you aren’t able to eat much, as the healing areas in your throat are kept clean by swallowing solid food. Certain techniques used for adenoidectomy can also cause a bad smell in the back of the nose. A bad smell doesn’t necessarily mean that you have an infection.
- Voice changes. The soft palate (at the back of the mouth) keeps air from flowing backwards from the mouth to the nose during speech and swallowing. After surgery, there’s more room in the back of the throat, and your voice may sound “whiny” (in contrast to the “clogged” sound that may have been there before surgery). With time, this improves as your palate compensates for the larger space. Very rarely, it persists and requires further treatment.
- Temporary regurgitation of swallowed liquids may appear through your nose.
- Change in taste sensation which is usually temporary.
The removal of your tonsils and adenoids doesn’t affect your immune system so you’re at no additional risk of infection.
Ask your surgeon about the results and risks associated with your surgery. Also ask about their own rates of patient satisfaction and the rate of complications following the surgeries they’ve performed.