This is a common problem that affects children more than adults but is nevertheless debilitating, resulting in increased use of antibiotics and time off work/school.
The infections can be either bacterial (e.g. streptococcal) or viral (e.g. Ebstein Barr Virus) which causes glandular fever. This particular viral infection may also need steroid treatment to reduce the swelling and certainly requires a lot of time off to recuperate.
Occasionally a collection of pus (an “abscess”) can develop around the tonsil resulting in a very painful, and sometimes dangerous, condition call quinsy. This needs to be drained under a local anaesthetic plus requires a hospital admission with intravenous antibiotics and analgesia.
Indications for a tonsillectomy
4 – 5 episodes of tonsillitis a year
More than 1 episode of quinsy
More than 1 hospital admission for acute tonsillitis
Obstruction of the airway causing sever snoring or apnoeic spells
A growth on the tonsil
Chronic tonsillitis leading to systemic sepsis
Tonsillectomy is a procedure designed to dissect the tonsils from the back of the throat and is carried out under a general anaesthetic. Any bleeding areas encountered are gently cauterized or tied with dissolvable ties.
Post operative care
• Patients must eat and drink to avoid bugs collecting at the site of the operation leading to post operative infections and potential bleeds. The chance of a bleed is around 1% and is usually dealt with conservatively. Very occasionally does a patient have to return to theatre.
• Drinking plenty of water should be encouraged as should eating of whatever foods the patient enjoys ( not just ice-cream and jelly!).
• Avoiding acidic products e.g. tomatoes, orange juice or spicy foods such as curry will help to reduce the pain.
• Pain control is paramount to encourage eating. Paracetamol with codeine will help this but non-steroidal analgesia should be avoided as they can occasionally precipitate some bleeding.