A tonsillectomy is an operation to remove the tonsils. The tonsils are lymph nodes, similar to those in the neck, armpit or groin, which lie in the throat on either side of the back of the tongue. They are made of lymphoid tissue, which is responsible for producing antibodies to fight off infection. The tonsils are only 1% of the total body lymphoid tissue, so they are not essential from this point of view.
Tonsillectomy (often accompanied by the removal of other lymphoid tissue at the back of the nose – the adenoids) is a very old operation, the first ones being performed in Egypt around 3000 BC. It was a much more common operation in the pre-antibiotic era before the second world war, as tonsillitis without antibiotics was a severe disabling disease that could be life-threatening. Today the operation is still necessary under certain circumstances. These include:-
- five attacks of tonsillitis in a year in a child, or three a year in an adult;
- an attack of quinsy (the formation of an abscess under the tonsil);
- obstruction of the airway or food passage by grossly enlarged tonsils;
- tonsillitis complicated by middle ear infections on two occasions;
- other rarer complications of tonsillitis.
Tonsillectomy is normally done under a general anaesthetic by an ENT (ear, nose and throat) surgeon. Adults stay in hospital for 2-4 days, children just overnight. Adults can return to work after two weeks, children can return to school after ten days. The degree of discomfort is about the same as an attack of tonsillitis, but without the accompanying fever and muscular aches. The operation would normally be postponed until any acute infection was controlled by antibiotics.