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Tonsillectomy & Adenoidectomy : Complication and Recovery

  • Posted on- Apr 17, 2018
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Tonsils and Adenoids

Both tonsils and adenoids are part of the immune system and are thought to be the body’s first line of defense against bacteria and viruses that enter the body.

However, these glands can become chronically infected or enlarged causing more harm than good. When infections and breathing problems persist, surgery to remove the tonsils and adenoids is typically recommended.

The surgical procedure to remove the tonsils is known as a tonsillectomy, and the removal of the adenoids is called an adenoidectomy. Because tonsils, adenoids and their associated complications go hand in hand, these two surgeries are often done simultaneously.

The combined procedure is called a tonsillectomy and adenoidectomy (T&A) and is one of the most common surgeries performed.

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Tonsils and Tonsillitis

The tonsils are a pair of soft tissue masses located at the back of the throat on each side of the root of the tongue. The tissue of the tonsils is similar to lymph node tissue and is covered by a mucosa lining. As part of the lymphatic system, the tonsils help fight infection.

Tonsillitis refers to inflammation of the tonsils. Tonsillitis most commonly affects children, but adults can suffer from the infection as well. There are several types of tonsillitis.

Acute Tonsillitis: Acute tonsillitis occurs when a virus or bacteria infects the tonsils and causes swelling. Sometimes a grayish while coating (exudate) covers the tonsils. Patients typically feel a sore throat with acute tonsillitis.


Chronic Tonsillitis: Chronic tonsillitis can be repeated episodes of acute tonsillitis or a persistent infection that does not clear up with antibiotic treatment.

Peritonsillar abscess: A peritonsillar abscess occurs when an infection creates a pocket of pus next to the tonsil. These abscesses need to be drained immediately.

Common causes of tonsillitis

Bacterial and viral infections cause tonsillitis. Bacterial infections are most common in children 5 to 15 years of age, while younger children are more likely to develop tonsillitis caused by a viral infection. Some common causes include:

Symptoms of Tonsillitis

When the tonsils become infected, inflammation and swelling occurs and causes a number of symptoms:

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Diagnosis and Treatment for Tonsillitis

Treatment for tonsillitis depends on the underlying cause of infection and the age of the patient. Because the tonsils are visible, a physician can typically make a diagnosis by looking at the tonsils to see if they are swollen or have a coating.

If a bacterial infection is suspected, a rapid strep test or a throat swab culture will likely be performed. If the test is positive, an antibiotic (usually a ten-day course of the medication) will be prescribed. If the test is negative, a viral infection is typically assumed to be the cause.

When infections don’t clear up or continue to occur and the patient is experiencing unpleasant symptoms, surgery is usually the next option.


Tonsillectomies are often performed to treat the following conditions.

Chronic tonsillitis: When infections do not respond to treatment, or when episodes are frequent, tonsillitis is considered to be chronic. Frequent episodes of tonsillitis are defined as infections occurring more than 7 times in one year, more than 5 times in 2 consecutive years or more than 3 times in 3 consecutive years.

Enlarged tonsils: Tonsils can be naturally large and obstructive, or they can become enlarged due to chronic tonsillitis. Enlarged tonsils can cause difficulty breathing, swallowing, and sleeping.

Rare conditions: Sometimes tonsils are affected by rare diseases and conditions, such as cancerous tissue on the tonsils or recurrent bleeding from blood vessels near the surface of the tonsils.

A tonsillectomy is typically an outpatient procedure. If there are complications, or if the child is very young, an overnight hospital stay is possible.

The procedure is quick, typically lasting about 20 minutes, and is performed through an open mouth without any incisions through the skin. The surgeon may use a blade to remove the tonsils or a specialized surgical tool that uses either heat or sound waves to destroy or remove the tissue and stop the bleeding at the same time.

A newer procedure known as intra-capsular tonsillectomy is a variation of a traditional tonsillectomy. In this procedure, a small layer of tonsil tissue is left in place to protect the underlying muscles.

Adenoids and Adenoiditis

Adenoids are a collection of lymphoid tissue located far back in the throat near the nasal passages. They are positioned behind the soft palate and cannot be seen through the open mouth.

Like tonsils, they are part of the lymphatic system and help the body fight infection by producing antibodies that bind to and trap bacteria and viruses before they can travel further down the throat.

Typically, adenoids are larger in children and shrink as the child grows older. Several complications can occur with adenoids that cause problems for many children.

Symptoms of Adenoiditis

Children that suffer from adenoiditis typically experience one or more of the following symptoms:

Treatment for Adenoiditis

If adenoids are suspected to be a problem, an ear, nose, and throat specialist (ENT) can view the adenoids using an endoscope (a thin tube with a camera inserted through the nose).

Adenoiditis is typically treated with antibiotics first. If the child has repeated episodes of adenoiditis, chronically enlarged adenoids, chronic sinus infections, repeated ear infections, or sleep problems, surgery may be recommended.


An adenoidectomy is a common, simple, outpatient procedure with very few side effects. The adenoids are removed through the mouth without any external incisions.

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