The trials of tonsillitis

When is tonsillectomy needed?
When antibiotic treatments, supportive measures and other non-surgical treatments for recurrent tonsillitis are no longer effective, then tonsillectomy and/or adenoidectomy - surgical removal of the tonsils and/or adenoids - is often recommended.

Each individual is different, but past research shows that tonsillectomy or adenoidectomy, or both, is a beneficial form of treatment for those who have had six to seven infections in one year or two to three infections each year for more than a few years. In these cases, chronic infections can often cause secondary infection in other areas, especially the middle ear.

The operation is carried out under general anaesthetic, and requires only a 24- to 48-hour hospital admission in most cases. Apart from the usual anaesthetic 'risks', there is the associated risk of bleeding from the site where the tonsils were removed. This can occur immediately following the operation or up to ten days afterwards, when the scab covering the operation site falls off. The amount of bleeding in most cases is very small, and causes no problems, but about one to two per cent of patients may have bleeding severe enough to require a further visit for emergency treatment.

What about recovery?
There is always a very sore throat. Sometimes this can become severe enough to prevent swallowing - even of liquids - and there is always a need to prevent dehydration. Soreness will be helped by the use of a suitable liquid analgesic medicine and by sucking ice or sipping iced drinks, etc. There is no evidence that any special diet is required, but obviously soft foods will go down more easily.

Some children can have vomiting or develop a high temperature - which can be indicative of a secondary infection - and this can also lead to pain in the ears, as occurred during the bouts of tonsillitis. In these cases, antibiotic treatment may be necessary once again.