Tonsillectomy

Adenoids and tonsils are highly important lymphoid tissues in the body's immune system, responsible for producing lymphocytes. The tonsils are located at the entrance of the throat, on both sides of the base of the tongue. The adenoids, on the other hand, are located in the space behind the nose. Lymphocytes and antibodies produced by the tonsils and adenoids play only a supportive role in the immune system. The main role in this system belongs to mucosal immunoglobulins and systemically produced lymphocytes. Tonsils are covered by a kind of capsule and are connected to the pharyngeal muscles by this capsule. Adenoids do not have a capsule. They are located on the tissues in the region we call the nasopharynx.

Why Does the Body Need Tonsils?

Every region in the human body has specific functions. Tonsils also have their own unique functions. However, it is not an absolute necessity to have tonsils. For this reason, the most frequently performed surgical operations worldwide, especially in childhood, are adenoid and tonsil surgeries. The main point here is that the tonsils or adenoids are removed for a valid reason.

Why Do Tonsils Swell?

Tonsils swell when they come into contact with viruses or bacteria and an advanced infection occurs. It manifests itself with complaints such as fever, sore throat, weakness, difficulty swallowing, swelling of the neck glands, and bad breath.

How is the Decision Process in Tonsil and Adenoid Surgery?

The decision for adenoid and tonsil surgery is made within the scope of certain infections. These are:

• Tonsils growing large enough to make swallowing and breathing difficult
• Having had 3 or more infections in a year
• Bad breath caused by the accumulation of food on the tonsils
• Unilateral enlargement of the tonsils
• Hearing loss as a result of fluid accumulation in the ear caused by adenoids and tonsils
• Enlargement of adenoids enough to cut off breathing
• Frequent sinusitis attacks and persistent adenoid inflammations that cause coughing

Are Tonsils and Adenoids Removed Together?

Tonsil surgery should be performed when deemed appropriate. Especially in pediatric patients, since tonsils and adenoids are similar lymphoid tissues, tonsil and adenoid problems often arise together, and in the event of a surgery, both are removed together. The mentioned lymphoid tissues are generally removed for two reasons. The first of these is that the size of the adenoids and tonsils blocks the airway, and the other is frequent recurrent inflammations. If tonsils enlarge, they can cause problems with feeding, swallowing, and speaking.

Food crumbs accumulated on the tonsils can also cause bad breath. Above all, the large size of the tissue called adenoid leads to nasal congestion. This condition causes problems in patients such as snoring and sleeping with an open mouth. Along with this, adenoids being obstructively large causes developmental disorders in the jaw and facial bones. This situation will reveal the appearance called ‘adenoid face’. Additionally, fluid accumulation in the middle ear and accompanying hearing loss can cause pharyngitis, coughing, and sinusitis due to postnasal drip. Frequent recurrent tonsil infections can cause problems in the joints, kidneys, and heart. In such cases, adenoid and tonsil surgeries may be considered appropriate.

When Should Tonsil Surgery Be Performed?

Tonsil removal procedures can be performed at almost any age. Generally, unless sleep apnea occurs during night sleep, after 2.5 years of age is considered appropriate for tonsil surgery. Adenoids can be removed at a younger age if deemed appropriate. There is no upper age limit for tonsil surgery. However, in adults, complications such as pain and bleeding are frequently seen after tonsil surgery.

Tonsil problems generally disappear after childhood. As age increases, the airway diameter will increase, and situations like obstruction will not occur. As the immune system strengthens with advancing age, a decrease in tonsil infections is observed. However, tonsil infections in adulthood are much more severe. The healing process can be prolonged, which can negatively affect social life.

Up to What Age Should Tonsils Be Removed?

While tonsil surgeries can be performed at any age, they are applied more frequently to children in the average 3-5 age group. But if there are mandatory reasons, waiting for the child to grow would be dangerous, so it can be done earlier upon the approval of a specialist doctor.

Is There an Appropriate Season for Tonsil Surgery?

Tonsil surgery can be performed in almost any season. However, it is not appropriate to perform it especially in the summer months when the weather is very hot. Small children's fluid intake may be restricted due to severe pain after the surgery, and an increase in complications may be observed. Winter or spring months are generally preferred for this operation.

Does Tonsil Surgery Carry Risks?

As in all operations, there are some risks in adenoid and tonsil surgery. However, these are very few. Especially since this operation is frequently performed on children, both surgical and anesthetic interventions must be performed very carefully and meticulously. Since the operation to be performed is in the airway, it should be done by an anesthesia team experienced in their field. Recent innovations and drugs in the field of anesthesia have minimized possible complications.

How is Tonsil Surgery Performed?

The surgery is performed under general anesthesia. By this means, the child will not even realize that they are having surgery. The adenoid or tonsil surgery will be completed without the need for any incisions. After an operation lasting about 1 hour in total on average, the child will be taken to the recovery room. After staying in the hospital for an average of 5-10 hours, if there are no unexpected complications, they will be discharged.

How is the Post-Operative Process?

Pain may occur in adult patients after surgery. However, the pain that may occur in children can generally be prevented with simple painkillers. Bleeding that may occur after surgery should also be taken seriously. Bleeding is seen on the first day, provided it is not excessive. This is a normal process. However, if the bleeding still continues in the following days or becomes severe, it is absolutely necessary to contact a specialist doctor without wasting time. Although rare, re-operation may be necessary for bleeding control. Post-operative dietary habits are important to reduce complications. Hard and difficult-to-swallow foods should not be consumed. Liquid-heavy foods should be preferred. Adenoid and tonsil surgery generally yield successful results if performed by a specialist doctor in a well-equipped health center or hospital.