Tonsils play an important role in keeping you healthy. These small, oval-shaped pads on the back of the throat are part of the immune system and produce white blood cells. These cells attack and defend against germs that enter your body and make you sick.

Although small in size, tonsillitis can cause considerable pain and discomfort. This inflammation is called tonsillitis and is usually caused by a viral infection, although bacterial infections can also cause tonsillitis.

Image of tonsils

Children are more susceptible to tonsillitis than adults for a few reasons. First, at daycare or school they are constantly surrounded by germs. Children are not as good at hand washing and sneezing or coughing etiquette, so they have more germs in their environment. They easily catch a cold, which can lead to a cold and tonsillitis. They have short throats and many have large tonsils, which can cause shortness of breath and sleep apnea.

Sometimes, a person can get tonsillitis once or twice without any problem. But for some people, it happens repeatedly, doesn’t respond to treatment, or causes complications. A common procedure called tonsillectomy, which involves surgically removing the tonsils, may be recommended in these cases.

Tonsillectomy is more common in children, but some adults need them too. Tonsillectomy is the second-most common procedure performed by otolaryngologists, who specialize in diagnosing and treating conditions of the ear, nose, throat, head, and neck.

People who experience these symptoms may benefit from a tonsillectomy:

  • Recurrent or chronic sore throat
    A recurrent sore throat is a sore throat a few times a year, while a chronic sore throat lasts two or three months. These painful conditions do not seem to resolve on their own.
  • Frequent tonsillitis
    Generally, it is defined as at least seven episodes in the previous year, at least five episodes per year for the past two years, or at least three episodes per year for the past three years.
  • Sleep apnea caused by enlarged tonsils
    When the tonsils are too large, they can cause obstructive sleep apnea. Enlarged tonsils block the airway, disrupting breathing and sleep.
  • Different sizes of tonsils
    Generally, the tonsils are about the same size. When one is significantly larger than the other, both tonsils should be removed to rule out throat cancer or other serious conditions.

In the past, a tonsillectomy sometimes required a hospital stay of several days. That has changed, and most patients can go home the same day as their surgery. The procedure takes 30-45 minutes and is performed under general anesthesia in an operating room.

Most patients experience some pain after surgery, such as a bad sore throat. It usually lasts about a week. I recommend that most people stay home from school or work, drink plenty of fluids, and eat soft foods during this time.

Pain usually subsides and most people are back to normal after about two weeks. They may experience more pain when yawning because that motion stretches the surgical site and the throat. This is normal and will decrease over time.

Overall, a tonsillectomy is a safe procedure, but there is a small risk of bleeding at the incision site. Over time, a cut on your hand forms a crust over the pore similar to the structure on your body. There is a slight risk of bleeding if the scab falls off seven to 10 days after surgery.

Talk to your healthcare team if you or your child’s tonsils appear enlarged or different in size, or if either of you has a chronic sore throat.

Pao Vang, MDis an otolaryngologist in Eau Claire and Rice Lake, Wisconsin.

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