Recurrent tonsillitis occurs not only in childhood but also in adults. When infections happen repeatedly, tonsillectomy in adults may be considered as a possible treatment option. While surgery can prevent further episodes of tonsillitis, it carries certain risks, primarily postoperative bleeding. Inflammation of the tonsils can lead to symptoms such as a sore throat and difficulty swallowing. If bacteria are the cause, antibiotics are often the first line of treatment. However, if the tonsils become inflamed repeatedly, the question may arise whether it would be better to have them partially or completely removed. Deciding on a tonsillectomy in adults involves weighing the pros and cons: On the one hand, there is the hope that inflammation will occur less frequently or not at all after surgery. On the other hand, there are the risks of the procedure and the question of whether it can truly provide lasting relief.

Intervention under certain conditions

Intervention is usually considered only under certain conditions. Surgery may be an option if bacterial tonsillitis occurs three to five times per year, antibiotics have been required repeatedly, and the symptoms are particularly severe or distressing. It is also important to rule out a viral cause whenever possible, as viral and bacterial tonsillitis can be difficult to distinguish. A throat swab can help detect bacterial infection.

Typical signs of bacterial tonsillitis include a fever above 38°C, swollen and painful lymph nodes in the neck, pus-coated tonsils, and the absence of a cough. In addition, complications such as a peritonsillar abscess (a collection of pus around the tonsils) may also be a reason to consider surgery.

What are the benefits of a tonsillectomy?

A complete removal of the tonsils (tonsillectomy) can help reduce the frequency of sore throat infections. While the palatine tonsils can no longer become infected, other tissue in the throat may become inflamed. Two small studies indicate that adults experience fewer sore throats after tonsillectomy. However, since the studies only lasted six months, it's impossible to say precisely how significant the long-term benefits of tonsillectomy are. The studies showed:

Without surgery: The study participants had approximately 2 to 7 episodes of sore throat in the six months following the start of the study.

With surgery

The participants who underwent surgery experienced approximately one episode of sore throat in the six months following the procedure. Depending on the study, they were also ill for 10 to 35 fewer days than the participants who did not undergo surgery. The benefit of surgery depends on the severity of the symptoms and whether the inflammation originates from the tonsils or the surrounding tissue.

What are the reasons against surgery?

• Tonsillitis may become less frequent over time, even without surgery. This is unpredictable. However, it's advisable not to rush into surgery but to wait and see if the problems subside. If they don't, surgery can still be considered.

• The first few days after a tonsillectomy are often uncomfortable because the wound can be painful, and swallowing may also be difficult. The discomfort may subside after a few days, but sometimes it can last for one to two weeks. Temporary nausea and vomiting, difficulty swallowing, and taste disturbances can occur. Complications such as bleeding are also possible.

• Some people fear that removing the tonsils weakens the immune system and, for example, increases the risk of respiratory infections. Whether this is true, however, has not been scientifically proven. The tonsils do play a more important role in the immune system during the first few years of life than later on.

Conclusion

The wound may bleed again after the operation. Such bleeding usually occurs within the first week after the procedure, but it is possible for up to four weeks afterward. Warning signs include frequent swallowing and blood in the saliva. The blood may also enter the trachea or be vomited up. If any of these symptoms occur, it is important to seek immediate medical attention from experienced ENT consultants West Yorkshire, as post-operative bleeding can become a medical emergency requiring urgent treatment.

• Because post-operative bleeding can lead to significant blood loss, it is considered an emergency. While bleeding sometimes stops on its own, blood transfusions and possibly further surgery may be necessary.

• The risk of postoperative bleeding depends, for example, on the surgical procedure, age, and whether there is an increased tendency to bleed. Studies show:

• About 5 out of 100 adults experience post-operative bleeding.

• Approximately 1 in 5 of these adults will undergo surgery again.

• The voice may temporarily sound nasal. Sometimes food or liquid may come out of the nose. However, this usually subsides after a few days to weeks.

• Like all surgeries, a tonsillectomy carries general risks such as impaired wound healing, infections, or side effects of anesthesia.