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Adult Tonsillectomy

Medically Reviewed by Brunilda Nazario, MD on September 08, 2020

What Is a Tonsillectomy?

A tonsillectomy is surgery to have your tonsils removed. Children who have sore throats often or who snore might have their tonsils taken out. But tonsillectomies aren't just for kids. Adults can need them, too. It's done the same way in children and adults, but an adult's risks and recovery can be different.

Why Would an Adult Need a Tonsillectomy?

Your tonsils are two clumps of tissue that sit in the back of your upper throat. They're a part of your immune system. They trap germs that get into your body through your mouth or nose.

Your tonsils can be swollen or become infected. If you've ever had strep throat, you likely had an infection in your tonsils. Getting infections often can cause breathing problems or sore throats that don't go away.

Reasons you might have your tonsils removed as an adult include:

  • Chronic throat infection, which is the most common reason. Adults who have the surgery typically have had several sore throats over the past 1 to 3 years or have had a sore throat and swollen tonsils caused by infection for at least 3 months. Your sore throat might get better with antibiotics, but it comes back as soon as you're done with the treatment.
  • Obstructive sleep apnea (if a blockage of your upper airway is caused by swollen tonsils)
  • Bad breath that doesn't go away (if caused by a collection of pus and debris in your tonsil area)
  • Cancer (spread from your head or neck area)

Men are more likely to have their tonsils removed than women.

How Do I Get Ready?

Your doctor will want to know about any medicines or supplements you take. This includes over-the-counter medications, such as aspirin, as well as herbs and vitamins.

Your doctor may tell you to stop taking certain medicines. For example, 2 weeks before surgery, you won’t be able to take:

  • Aspirin or any medicines that have aspirin
  • Ginkgo biloba
  • St. John’s wort

Your doctor will also ask about:

  • Your reactions or allergies to medicines
  • Problems that you or your family members have had with drugs used for anesthesia
  • Bleeding problems that you or your family members have, such as issues with blood clotting

Starting at midnight the night before the surgery, you won’t be able to eat anything. You may be able to have some liquids, but check with your doctor to see what’s allowed.

Adult Tonsillectomy Procedure

The procedure takes about 30 to 45 minutes. You'll be given general anesthesia, so you'll be asleep and pain-free during the surgery. Some people react to the drugs or gasses used for this. That’s why your doctor will ask you lots of questions about your medical history.

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The surgeon might use a small knife called a scalpel to gently remove your tonsils. Other they might prefer a tool that uses heat, sound waves (ultrasound), laser, or cold temperatures. They work just as well, and your recovery time is the same with all of them.

You may also have your adenoids taken out at the same time. They're also part of your immune system, and they sit close to your tonsils, up behind your nose and the roof of your mouth. This part of the surgery is called an adenoidectomy.

After surgery, your health care team will watch vital signs, such as heart rate and breathing, to make sure nothing goes wrong. As you wake up, you might feel sick to your stomach or even throw up. That’s part of the anesthesia wearing off and is common. If you're doing well after a few hours, you'll likely be sent home to recover. But if you have a lot of bleeding from the wound, severe vomiting, trouble breathing, or other problems, you'll probably stay in the hospital overnight.

Adult Tonsillectomy Risks and Complications

A tonsillectomy is considered a safe procedure for adults. However, all surgery comes with risks. A 2014 report found that 1 in 5 adults who had their tonsils taken out had some kind of problem afterward. These included:

  • Dehydration
  • Infection. This is rare, but it’s a small risk with most surgeries.
  • Pain
  • Pneumonia
  • Too much bleeding from the wound (hemorrhaging). It’s rare. You may also have bleeding as you heal.
  • Swelling. In the first few hours after surgery, your tongue and the roof of your mouth may puff up, which makes breathing harder.

You're a lot more likely to have one of these issues if you have:

  • A history of pus collecting on your tonsils (peritonsillar abscess)
  • Another health problem
  • Used antibiotics often in the past year

Adult Tonsillectomy Recovery

Adults need about 2 weeks. These tips can help you feel your best while you recover:

  • Take your pain medication as your doctor prescribed. The pain will be worse immediately after surgery -- it should start to go away after the first week. Almost everyone gets a sore throat. You may also hurt in your ear, neck, or jaw. Your doctor will let you know what medicines you can take for relief. Call your doctor if your pain gets worse instead of better.
  • Suck on ice cubes to help with throat pain.
  • Drink plenty of water, apple juice, and other clear fluids to stay hydrated.
  • Drink smoothies or eat soft foods to make sure you get enough nutrition.
  • Don't try to do too much too soon after surgery. Let your body recover.
  • Watch for signs of infection. Your doctor will discuss these with you, but you should call them if you have any trouble breathing, bleeding, pain that gets worse, signs of dehydration (you don't have to pee often), or a fever over 102 F.

Generally, you’re ready to get back to your typical routine when you can eat and drink as usual, when you sleep through the night, and when you don’t need medicine for pain.

When Should I Call the Doctor?

Symptoms such as pain, snoring, and fever under 102 F are normal after surgery. But call your doctor if you notice:

  • You feel weak, dizzy, lightheaded, or have a headache. This could mean you haven’t had enough fluids.
  • You have a fever 102 F or higher.
  • You throw up or still feel sick to your stomach more than 12 hours after surgery

Go to the emergency room if you have:

  • Trouble breathing
  • Any bleeding (small bits of dark blood in your nose or spit are normal, but bright red blood means you need to be seen by a doctor.)

Will My Tonsil Problem Return?

Most adults who have their tonsils taken out because of chronic infection say they:

  • Have fewer sore throats
  • Don't have to use antibiotics as often
  • Miss fewer days at work
  • Have fewer doctor's visits
  • Have better general health

Your surgeon will perform your tonsillectomy as an outpatient surgery, meaning you’ll be able to go home the same day. You’ll only stay at the hospital overnight if there are problems with your surgery or you have a complex medical condition.

WebMD Medical Reference

Sources

SOURCES:

American Academy of Otolaryngology - Head and Neck Surgery: "Tonsillectomy and Adenoids PostOp," "Tonsillitis," “Tonsils and Adenoids.”

CMAJ: "Short-term outcomes of tonsillectomy in adult patients with recurrent pharyngitis: a randomized controlled trial."

Cochrane: "Surgical removal of the tonsils (tonsillectomy) for chronic or recurrent acute tonsillitis."

Johns Hopkins Children's Center: "Tonsillectomy and Adenoidectomy."

News release, JAMA.

Otolaryngology -- Head and Neck Surgery: "Adult tonsillectomy: current indications and outcomes,"  "Prevalence of complications from adult tonsillectomy and impact on health care expenditures."

Specialty Surgical Center: "Adult Vs. Pediatric Tonsillectomy."

UpToDate: "Tonsillectomy in adults: Indications."

Mayo Clinic: “Tonsillectomy,” “Ear tubes,” “Tonsillectomy,” “Tonsillitis.”

Piedmont Healthcare: “When should your tonsils be removed?”

Cincinnati Children’s: “Tonsillectomy.”

St. Joseph’s Children’s Hospital: “Preparing Your Child for Surgery.”

KidsHealth: “Having Your Tonsils Taken Out.”

National Health Service: “Tonsillitis -- Treatment.”

Cleveland Clinic: “Tonsillectomy Overview.”

University of Missouri Health Care, ENT and Allergy Center: “Tonsillectomy.”

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