Removing the tonsils is referred to as a tonsillectomy. It is a procedure that an ENT (ear nose and throat) surgeon will perform in the operating room. It is performed on children as young as two on up to adulthood when the tonsils need to be removed.
Tonsils need to be removed due to several factors. One, there are repeated strep throat infections over a year or two-year period. The tonsils can develop abscesses which are cause to remove them right away. Also, in some people, the tissue swells to such a size that it is obstructing their airway. Snoring is usually the result, along with difficulty swallowing.
The Day before Surgery
Tonsillectomies are performed under general anesthesia. This means that you will be going asleep and an endotracheal tube is placed in the throat so that anesthesia personnel can monitor your airway. This means that you cannot eat or drink anything after midnight on the night before surgery, so that your stomach remains empty.
After you are asleep, a mouth gag is placed to hold your mouth open while cushioning your teeth. The surgeon can now use both hands to visualize and remove the tonsils. They have to be cut out of their beds completely to avoid any further problems.
Tonsils can be removed in different ways. Some doctors may use a scalpel. The challenge with the scalpel approach is blood loss and control. Cutting through tissue will lead to bleeding but with a scalpel, it is hard to see what is going on when there is too much blood.
Many surgeons use electrocauterization. This is the process of using cautery to cut the tissue and seal it at the same time. As bleeding occurs, the surgeon can cauterize it right away. There is also a cautery instrument that suctions as it coagulates for better visualization.
Some surgeons like to minimize trauma to the surrounding tissue with a laser approach. Lasers are pinpoint accurate and can reduce bleeding. The surgical removal is cleaner.
The surgeon will also take a look at the adenoids. This is a pad of tissue that grows in the back of the throat. When the tonsils are enlarged, sometimes the adenoids are too. They can lead to snoring or what is typically called obstructive sleep apnea. This tissue can be cauterized and burned away or removed with sharp instruments.
At the end of the procedure, the area is checked for any residual bleeding and irrigated out. Your throat will be sore for a while due to the cauterization.