Tonsillectomy for adults

A tonsillectomy is a straightforward outpatient surgery to remove one or both tonsils.

Your tonsils shrink and become less important for immune defence after your first few months of life, so having them removed as an adult doesn’t stop your body from being able to fight infections.

The surgery is a day- case and takes around 30 minutes. 

What are tonsils? 

Your tonsils (also known as palatine tonsils or faucial tonsils) are glands on either side of the back of your throat. They are made up of lymphoid tissue (part of your immune system) and play a role in protecting you from infection. 

Signs of needing a tonsillectomy

You may need a tonsillectomy if you have tonsillitis more than 4 times a year, or if your tonsils have swollen and started to block your airway, which can cause breathing problems, snoring or obstructive sleep apnoea.

Although rare, your doctor might suggest removing your tonsils if they suspect there is a tumour inside one of them and they want to perform a biopsy on it.

Is a tonsillectomy right for you?

Some throat issues will get better on their own, so your doctor will discuss your specific case to determine whether a tonsillectomy is right for you. While surgery will prevent tonsillitis from recurring, it won’t prevent other causes of a sore throat, like pharyngitis or laryngitis.

A tonsillectomy may also help with snoring and sleep apnoea if your tonsils are obstructing the airway during sleep.

Alternative treatments to a tonsillectomy

Topical steroid sprays and/or drops can be helpful. While they can’t resolve an infection or reduce the size of your tonsils, they may provide relief from your symptoms.

One or both tonsils will be removed under a general anaesthetic. As the surgery is performed through your mouth, you will not have any visible scars on the outside of your body.

Your mouth will be held open using a specially designed instrument called a gag. The gag will also push your tongue down so that your surgeon will have clear access to your tonsils.

Your tonsils will be removed either using special scissors, with the wound sewn together using dissolvable stitches, or using diathermy, where heated surgical instruments are used to remove the tonsils and seal off the wound.

How to prepare for your tonsillectomy

You’ll need to complete a pre-admission form. List any allergies, medications you are taking, including supplements, and whether you or anyone in your family has bleeding or bruising issues. You may need to attend hospital for additional tests, such as blood tests.

It helps to be in good health before your surgery. Try to follow a healthy, balanced diet, ensure you get enough sleep, stay active, manage your weight, and quit smoking if you can.

You’ll be asked to fast (ie to stop eating and drinking) for a number of hours before you have a general anaesthetic. Follow the instructions in your admissions letter on how long to fast for and whether you need to stop taking any medications ahead of your procedure.

Although your surgeon will need access to your head and neck, you’ll be given a hospital gown to change into so your care team can attach monitors to your chest.

Who will be involved?

Your care team will include an experienced ear, nose and throat (ENT) surgeon (an otolaryngologist), an anaesthetist and specially trained nurses.

You will be able to select the surgeon of your choice from our team of expert ENT consultants and book your appointment at a time and date that best suits your schedule.

The procedure

Your anaesthetist will administer a general anaesthetic so you’ll be asleep and won’t feel anything during your surgery.

The procedure usually takes around 30 minutes and typically involves your tonsils being removed with special scissors. Sometimes heat is used to stop any bleeding.

Pain during and after surgery

While you won’t be able to feel anything during your surgery, it’s normal to feel some discomfort in the throat and some people experience referred pain in their ears afterwards ie pain starts in the throat and is transmitted to the ears through a nerve. You’ll be given painkillers to manage your pain immediately after the procedure and for the next 5–10 days.

What happens straight after the procedure?

You’ll be taken to a recovery room and monitored as you come around from the anaesthetic. It’s common to feel sick or dizzy after a general anaesthetic, but this should resolve on its own in around 24 hours. Your care team will administer any pain medication as required.

Your hospital stay

You can likely go home on the same day, but you may need to stay overnight for monitoring. You’ll need to eat and drink in the first 1–2 hours after surgery if you’re not feeling sick, and to pass urine before you can go home.

The first 24 hours

You may have short-term side effects from the general anaesthetic, like feeling sick, clumsy or slow for the first 24 hours. You should avoid driving, operating heavy machinery, or making any important decisions during this time.

Continuing recovery at home

Your care team will be available if you have any questions or concerns, and you’ll have a follow-up appointment to check your recovery. Most people are back to their usual activities within 2 weeks.

Pain

Start taking prescribed pain medication, usually every 4–6 hours, as soon as you get home. Preventing pain and swelling is more effective than treating it. It’s common for discomfort to worsen after about a week before resolving around 2 weeks after surgery.

Wound care

You may notice a yellowish-white coating at the back of your throat, and that your breath smells while the wound heals. This is normal and doesn’t mean you have an infection. You might be able to see the dissolvable sutures (stitches), which will dissolve in a few weeks.

Practise good hygiene and avoid crowded or smoky places to minimise the chance of irritation and infection.

If you are prescribed antibiotics to prevent infection, make sure to complete the whole course.

Food and drink

It’s important to manage your pain so you can eat and drink normally. This will help to avoid the build-up of inflammation or scar tissue at the back of the throat, which can cause bleeding and infections.

Food may taste different while you heal, so you may prefer bland flavours. Chewing gum stimulates saliva production, which keeps the throat moist and helps to manage pain.

Smoking

Quitting smoking can support wound healing and reduces the risk of strain on your throat from coughing.

Driving

Avoid driving for at least 24 hours until you’re fully recovered from the anaesthetic and can confidently make an emergency stop.

Time off work
Most people take around 2 weeks off work. At first, you’ll feel tired and need a lot of rest, but you’ll gradually improve. Staying at home during this time will minimise your chance of infection.

Sport and activity

Getting moving after your surgery is helpful for your recovery, but you should avoid strenuous exercise for a couple of weeks to minimise your risk of bleeding.

Although rare, any operation carries some risks:

• A few in 10 people experience short-term general anaesthetic side effects, such as nausea, vomiting, dizziness, headache, blurred vision or memory loss
• A few in 100 people experience bleeding during or shortly after the operation
• A few in 100 people develop a wound infection
• A few in 1,000 people develop deep vein thrombosis (DVT) or a pulmonary embolism (blood clot)
• A few in 10,000 to 100,000 people experience a serious allergic reaction to the anaesthetic

A tonsillectomy is considered a very safe procedure; however, there are a few additional risks:

• A few in 100 people experience temporary tongue numbness, which usually resolves on its own
• A few in 1,000 people sustain damage to their teeth, lips, gums or tongue during surgery

Seek urgent medical attention if you experience:

• A cough, shortness of breath or chest pain
• Fever
• Inability to eat or drink normally
• Increasing pain, redness, swelling, bleeding or discharge from the wound
• Persistent or increased bleeding
• Swelling in your calves