Introduction

The tonsils or tonsils for short consist of lymphoid tissue and are located in the oral cavity, in contrast to the adenoid (also called "polyps") which consists of the same tissue and is located at the back of the nose in the nasopharynx. The adenoid is frequently hypertrophic and chronically infected in children. The following information will provide you with generally accepted information about this type of operation. Your surgeon is at your disposal to assist you with any further questions. Remember to report to your surgeon any information regarding your general health, as well as any medications you regularly take (especially aspirin and related products or medications that may affect clotting). Do not forget to report if you have experienced any allergic reactions, especially reactions to medication. Bring recent medical records in your possession such as blood tests, radiologic and other preoperative examinations.

Purpose of the procedure

Removal of the tonsil is indicated in recurrent acute and chronic infections or their complications, and also if they have an impeding effect on breathing, swallowing and voice formation due to their volume. Removal of the adenoid, of course usually in children, is indicated in persistent nasal obstruction symptoms and in recurrent nose and throat infections and their complications, in particular recurrent ear infections. In most cases, your doctor will only decide on surgical intervention if drug treatment proves to be insufficient. Nasal infections and ear infections can sometimes still occur after removal of the adenoid.

The technical aspects of the operation

The procedure is usually performed under general anaesthetic. The procedure is performed through the mouth, for both the removal of tonsils and tonsils. The tonsils are usually dissected ("peeled") while the adenoid is curetted ("scraped").

Immediate Effects

When the adenoid is removed, the postoperative course is usually without problems, sometimes there is a slightly bloody nasal secretion during the first hours. When the tonsil is removed, there is a wound in the throat on both sides, which will heal over the course of 10 to 14 days. During the first few days a white-grey, somewhat bad-smelling coating forms on the wound. Swallowing is especially difficult during the first few days with sometimes radiating ear pain. The diet has to be adjusted and sometimes painkillers are needed. The length of stay and post-operative care will be communicated to you by the surgeon. The manipulations with instruments in the oral cavity can result in small wounds of the lip, tongue or even prying of a (milk) tooth. The most important immediate risk is bleeding, which necessitates reoperation, or less frequently an infection such as an additional ear infection or throat abscess.

Late Effects

A late bleeding after about 10 days is rare. Sometimes this requires a new anesthetic with pen and/or stitches. Rarely occurs after healing, when speaking, air loss through the nose (nasality) for which speech therapy is indicated. Almond remains can persist or grow and give rise to infectious symptoms. Tonsils can grow back, especially when removed in children 2 years or younger (although this is certainly not the rule).

Serious and/or exceptional complications

Any surgical procedure, even performed under ideal conditions and in the best possible way, can entail complications. A massive bleeding, during or immediately after the procedure is exceptional, must be surgically stopped under general anesthesia (tamponing, suturing, ligation of blood vessels). Mucus and blood can be inhaled during or immediately after the procedure, responsible for respiratory infections that may require medical treatment. Phlegmon or abscess formation in the neck area is rare. High fever, pain and swelling in the neck area are the typical features that justify an emergency consultation. All of these risks must be weighed against complications that may arise if surgical treatment is not initiated.

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