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Tonsillectomy

What Are Tonsils?

Your palatine tonsils form a protective ring around the back of your throat and act as your body’s first line of defense against viruses, bacteria, and germs that enter the mouth. These two, small, oval-shaped glands are a part of your body’s immune system housing white blood cells that help you fight off infections. Unfortunately, they can become infected themselves (tonsillitis), and if you find yourself with recurring episodes of tonsillitis, you may benefit from a tonsillectomy.

Woman with tonsil discomfort in need of a Tonsillectomy Procedure by Orlandos Ear Nose Throat Specialists
Doctor considering a Tonsillectomy Procedure by Orlandos Ear Nose Throat Specialists

What Is a Tonsillectomy and Why Is It Performed?

This is a common surgical procedure that removes the palatine tonsils from the back of your throat. It is performed to treat infection and inflammation of the tonsils in individuals who have chronic or severe episodes of tonsillitis. A tonsillectomy is also used to treat complications from enlarged tonsils, such as difficulty swallowing or obstructive sleep apnea. It may also be used to treat rare diseases or conditions that affect the tonsils like cancer, tonsil stones, or halitosis related to the tonsils’ crevices.

What Is Tonsillitis & When Does a Tonsillectomy Benefit Sufferers?

This is an infection of the tonsils at the back of the throat. It is often accompanied by swelling, a sore throat, fever, trouble swallowing, and sometimes swollen lymph nodes in the neck. Your tonsils may become covered with a white or yellow coating, and your throat may be sore and red. Antibiotics are usually the first line of treatment. A tonsillectomy may be beneficial if:

  • You have had 7 episodes of tonsillitis in the last 12 months.
  • You have had at least 5+ episodes in the past 24 months.
  • You have had at least 3 episodes a year in the past 36 months.

A tonsillectomy is also the recommended course of action if antibiotic treatment does not improve the bacterial infection causing the tonsillitis. If the infection results in frequent peritonsillar abscess, which may not improve with medication or drainage, then a tonsillectomy is the next step.

Illustration of throat anatomy and tonsils
A throat specialist checking a patient to see if a Tonsillectomy Procedure is needed

How To Prepare for a Tonsillectomy Procedure

Our ENT physicians ask that you stop taking anti-inflammatory and anticoagulant medications one week prior to your surgery, as these increase the risk of post-operative bleeding. We also ask that you do not eat or drink after midnight on the night prior to your procedure, as this will prevent anesthesia complications. Finally, we ask that you have a responsible adult with you for a ride home as well as for aftercare for at least 24 hours after surgery. Recovery from tonsillectomy is may take up to two weeks.

How Long Does the Procedure Take?

A tonsillectomy usually takes around 30-45-minutes and is done under general anesthesia. Our ENT physicians here at Florida Otolaryngology Group will take a detailed medical history and physical exam that assesses medicatoons, dietary supplements, and allergies, a family history of bleeding disorders, or negative reactions to antibiotics and anesthetics.

A Throat doctor checking a patient before a tonsillectomy procedure
Health throat after a Tonsillectomy Procedure by Orlandos Ear Nose Throat Specialists

What Does Recovery Look Like After a Tonsillectomy?

You will experience pain during the healing process which will be treated with prescribed pain medication. Expect a sore throat, pain in the ears, neck, and jaw, as well as yellow discoloration where your tonsils were. This discoloration will look similar to a scab and will disappear a few weeks after the surgery.

It is important to eat soft foods during your recovery, such as popcicles, applesauce, broth, ice cream, and pudding. You want to avoid hard, spicy, or crunchy foods as these will cause pain or increase bleeding. Also it is important to avoid strenuous activities for the first 2-weeks and to get a lot of rest to help with the healing process.

Have Questions About the Tonsillectomy Procedure?

If you’d like to learn more about the benefits of tonsillectomies, our ENT physicians are happy to answer your questions or concerns. You can contact us here, or give us a call at: 407-677-0099. We serve the communities of Orlando, Winter Park, and Kissimmee.

Throat doctor checking to see if a patient needs a tonsillectomy procedure

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Painful ear infections are a rite of passage for children—by the age of five, nearly every child has experienced at least one episode. Most ear infections either resolve on their own (viral) or are effectively treated by antibiotics (bacterial). But sometimes, ear infections and/or fluid in the middle ear may become a chronic problem leading to other issues such as hearing loss, behavior and speech problems. In these cases, insertion of an ear tube by an otolaryngologist (ear, nose and throat specialist) may be considered.

Ear tubes are tiny cylinders placed through the ear drum (tympanic membrane) to allow air into the middle ear. They also may be called tympanostomy tubes, myringotomy tubes, ventilation tubes, or PE (pressure equalization) tubes. These tubes can be made out of plastic, metal or Teflon and may have a coating intended to reduce the possibility of infection. There are two basic types of ear tubes: short-term and long-term. Short- term tubes are smaller and typically stay in place for six months to a year before falling out on their own. Long-term tubes are larger and have flanges that secure them in place for a longer period of time. Long-term tubes may fall out on their own, but removal by an otolaryngologist is often necessary.
Ear tubes are often recommended when a person experiences repeated middle ear infection (acute otitis media) or has hearing loss caused by the persistent presence of middle ear fluid (otitis media with effusion). These conditions most commonly occur in children, but can also be present in teens and adults and can lead to speech and balance problems, hearing loss, or changes in the structure of the ear drum. Other less common conditions that may warrant the placement of ear tubes are malformation of the ear drum or eustachian tube, Down Syndrome, cleft palate and barotrauma (injury to the middle ear caused by a reduction of air pressure, usually seen with altitude changes such as flying and scuba diving).
Ear tubes are inserted through an outpatient surgical procedure called a myringotomy. A myringotomy refers to an incision (a hole) in the ear drum or tympanic membrane. This is most often done under a surgical microscope with a small scalpel (tiny knife), but it can also be accomplished with a laser. If an ear tube is not inserted, the hole would heal and close within a few days. To prevent this, an ear tube is placed in the hole to keep it open and allow air to reach the middle ear space (ventilation).

Each year, more than half a million ear tube surgeries are performed on children, making it the most common childhood surgery performed with anesthesia. The average age for ear tube insertion is one to three years old.

Inserting ear tubes may:

  • Reduce the risk of future ear infection
  • Restore hearing loss caused by middle ear fluid
  • Improve speech problems and balance problems
  • Improve behavior and sleep problems caused by chronic ear infections
A light general anesthetic (laughing gas) is administered for young children. Some older children and adults may be able to tolerate the procedure without anesthetic. A myringotomy is performed and the fluid behind the ear drum (in the middle ear space) is suctioned out. The ear tube is then placed in the hole. Ear drops may be administered after the ear tube is placed and may be necessary for a few days. The procedure usually lasts less than 15 minutes and patients awaken quickly.

Sometimes the otolaryngologist will recommend removal of the adenoid tissue (lymph tissue located in the upper airway behind the nose) when ear tubes are placed. This is often considered when a repeat tube insertion is necessary. Current research indicates that removing adenoid tissue concurrent with placement of ear tubes can reduce the risk of recurrent ear infection and the need for repeat surgery.

After surgery, the patient is monitored in the recovery room and will usually go home within an hour if no complications occur. Patients usually experience little or no postoperative pain but grogginess, irritability, and/or nausea from the anesthesia can occur temporarily.

Hearing loss caused by the presence of middle ear fluid is immediately resolved by surgery. Sometimes children can hear so much better that they complain that normal sounds seem too loud.

The otolaryngologist will provide specific postoperative instructions, including when to seek immediate attention and to set follow-up appointments. He or she may also prescribe antibiotic ear drops for a few days.

To avoid the possibility of bacteria entering the middle ear through the ventilation tube, physicians may recommend keeping ears dry by using ear plugs or other water-tight devices during bathing, swimming and water activities. However, recent research suggests that protecting the ear may not be necessary, except when diving or engaging in water activities in unclean water such as lakes and rivers. Parents should consult with the treating physician about ear protection after surgery.

Consultation with an otolaryngologist (ear, nose and throat specialist) may be warranted if you or your child has experienced repeated or severe ear infections, ear infections that are not resolved with antibiotics, hearing loss due to fluid in the middle ear, barotrauma, or have an anatomic abnormality that inhibits drainage of the middle ear.

Myringotomy with insertion of ear tubes is an extremely common and safe procedure with minimal complications. When complications do occur, they may include:

  • Perforation—This can happen when a tube comes out or a long-term tube is removed and the hole in the tympanic membrane (ear drum) does not close. The hole can be patched through a minor surgical procedure called a tympanoplasty or myringoplasty.
  • Scarring—Any irritation of the ear drum (recurrent ear infections), including repeated insertion of ear tubes, can cause scarring called tympanosclerosis or myringosclerosis. In most cases, this causes no problem with hearing.
  • Infection—Ear infections can still occur in the middle ear or around the ear tube. However, these infections are usually less frequent, result in less hearing loss and are easier to treat—often only with ear drops. Sometimes an oral antibiotic is still needed.
  • Ear tubes come out too early or stay in too long—If an ear tube expels from the ear drum too soon (which is unpredictable), fluid may return and repeat surgery may be needed. Ear tubes that remain too long may result in perforation or may require removal by an otolaryngologist.