Tonsillectomy: what it is, duration, cost and step by step

• The tonsils are lymph glands located on both sides of the pharynx. The main function of this structure is to protect us and to fight the batteries and viruses present in the environment.
• When the tonsils present an excessive size and this does not diminish with pharmacological treatments, the most advisable way to combat the pathology is usually surgical treatment, tonsillectomy.
• Tonsillectomy is a surgical procedure that lasts only 20 minutes. Thanks to this treatment, the tonsils are removed and the persistent pain and inflation are reduced.

First of all, it is important to know what tonsils are. They are oval-shaped structures made up of lymphatic tissue, located on both sides of the throat. The main function of the tonsils is to fight infection, acting as the first barrier against germs that can be ingested through the mouth and nose, especially during childhood.

These masses grow and develop until the age of 3-5 years, as the immune system evolves to fight off exposure to bacteria and viruses, i.e. as children become more immune to disease. They begin to shrink from the age of seven and by the end of adolescence they are practically imperceptible.

As we mentioned, the tonsils produce white blood cells, lymphocytes, to fight disease. This function can overstrain the tonsils, causing the glands to become highly inflamed, leading to sore or sore throats, blocked noses and ears, as well as tiredness, nausea and other uncomfortable symptoms such as pain when swallowing or eating, bad breath, a foreign body sensation in the throat, among others.

Keep in mind that tonsil pathologies usually disappear with the intake of drugs prescribed by the doctor as well as due to their natural tendency to decrease in size as we grow. But when drug treatment does not work and tonsil hypertrophy becomes very recurrent or chronic, specialists resort to the surgical treatment of tonsil removal.

Surgery is recommended for both children and adults, always under the expert supervision of an Otolaryngologist who will determine it according to the characteristics and particularities of each patient.

Tonsillectomy is a procedure that is performed under general anaesthesia, i.e. the patient remains completely asleep without discomfort, still and unaware of anything during the procedure. 

The patient remains in a supine position (lying face up) and with an instrument, called a mouth opener, carefully positioned to separate the jaws, allowing the surgeon to easily access the tonsils and dissect them.

It is possible to remove the tonsils using different techniques, these techniques are as follows:

• Cold dissection: the tonsils are removed by pinching the glands and traction, followed by small incisions with which they are sectioned and extracted from the throat. Once the process is complete, the area is cauterised, favouring the natural healing of the tissue without the need for sutures.
• Dissection with electrocautery: Dissection with electrocautery or electric scalpel is carried out in a similar way to that explained above. However, the instruments used can be monopolar or bipolar, the latter concentrating the energy on a minimal area. It is a fast surgery and achieves good intraoperative haemostasis (stopping bleeding). However, it is associated with greater postoperative pain than cold techniques and others such as radiofrequency and laser.
• Tonsillectomy with CO2 laser: Tonsillectomy with laser consists of the reduction and total removal of the tonsils by carbonisation with CO2 laser. It is a safe technique and provides less intraoperative bleeding, although it presents greater postoperative pain compared to cold dissection or dissection with an electric scalpel.
• Tonsillectomy with harmonic scalpel: The harmonic scalpel is an instrument that uses ultrasonic vibration to cut and coagulate tissues. Cutting is made possible by a sharp blade with a vibrating frequency and haemostasis is achieved by transferring energy to the tissues.
• Intracapsular tonsillectomy: this is performed using a microdebrider, which is an instrument with a cutting blade coupled to a continuous suction system and is performed in partial tonsillectomies or tonsil reduction, and is used above all in cases of obstructive sleep disorders. It is characterised as a technique that significantly reduces postoperative pain.
• Radiofrequency or Cold Plasma Ablation: This technique is performed using various means such as the Coblator or Plasma-Fision. In general, these are instruments that use bipolar radiofrequency energy transmitted to sodium ions, which creates a thin film of plasma at a temperature of between 40° - 85°. This reduces postoperative pain compared to techniques such as electrocautery. It is one of the most widely used techniques, along with cold dissection, for the surgical treatment of tonsil removal.

There are several reasons why tonsillectomy is performed, although they are mainly related to alleviating the discomfort caused to patients, especially children, as a result of pathologies that affect the functioning of the tonsils.

Although in principle, the function of the tonsils is to help the body fight infections (especially in the early stages of life), there are cases where they overdo their job and become permanently or habitually inflamed. 

This abnormal state can lead to complex symptoms, for example:

• Loud snoring
• Recurrent infections or abscesses in the throat
• Ear infections
• Hearing loss
• Cough
• High fever
• Development of group A streptococcal conditions

It is at this time that they are removed, but it is the specialist who will decide which treatment is best suited to you or your child. To do this, the specialist will carry out a thorough diagnosis to determine the cause of the inflammation and infection and its severity.

Who is a candidate for tonsillectomy?

As you have been able to see during this reading, the tonsils can undergo serious changes in their function and size for different reasons, which is why in most cases a patient is a candidate for tonsillectomy surgery. 

The most common reasons are the following:

• Chronic tonsillitis: when treatment of recurrent tonsillitis does not work with medication or other measures, surgery is the only option to avoid this problem.
• Frequent infections: the patient, probably your child if you are reading this, has infections on a regular basis. This can be around 7 or more times a year or in two years, which is why the patient misses a lot of school or work.
• Sleep apnoea and obstructive breathing problems: inflammation of the tonsils and adenoids is one of the main causes of sleep apnoea, so the doctor may recommend removal of the tonsils.
• Tonsil cancer: for the treatment of this type of problem, associated with people over the age of 50 who smoke, removal of the tonsils is also required.
• Chronic halitosis: in the case of suffering from halitosis on a regular basis and this is not resolved with the usual measures, it is possible that the patient suffers from problems in the tonsils and may require surgery to solve them.

However, as mentioned above, the main reason for surgery is that tonsils cause sore throats and infections on a very frequent basis.

As with all surgical procedures, tonsillectomy surgery requires a preoperative examination. This is to prevent any possible complications and ensure the patient's good health.

Tonsillectomy preoperative

The following tests are performed during the preoperative period for tonsillectomy:

• Electrocardiogram: this allows the doctor and the anaesthetist to know the patient's cardiovascular health and thus determine whether or not he or she is fit for the operation.
• Blood test: this test determines whether or not there is an infection in the body, in which case it must be checked before the operation.
• Chest x-ray: a chest x-ray is only performed when indicated by the doctor and allows to completely rule out signs of infection.

Once the pre-operative procedure has been performed, it is usual to have a consultation with the anaesthesiologist where the results will be reviewed and it will be determined whether you are fit to undergo the surgical procedure. 

During the anaesthesia consultation, you will be asked about your medication, lifestyle, etc. With all this, the anaesthetist will establish the levels of anaesthesia required to perform the operation.

Once everything is confirmed, the only thing left to do is to go to the hospital on the day of the tonsillectomy surgery.

How is tonsillectomy surgery performed?

On the day of the operation and at the hospital, you will first have to hand in the necessary documentation at the admissions desk. 

Next, the healthcare staff will indicate and help you to prepare for the surgery, you will be accompanied to the pre-surgical room where you will have to change your clothes and where the anaesthesia line and saline solution will be administered. 

As soon as everything is ready, you will be taken to the operating theatre. Once you have been placed on the stretcher in the position indicated by the doctor and the anaesthesia has taken effect, the tonsillectomy will begin:

1. The doctor will first place a tool in the patient's mouth to keep it open during the operation.
2. He then locates the tonsils and removes them with a scalpel, cauterising and closing the blood vessels with a tool called diathermy, which will allow faster natural healing without the need for sutures.
3. Once this process has been completed, which as you can see is very quick, the patient will be woken up.

The duration of the tonsillectomy procedure is approximately 20 minutes, it is an outpatient procedure, so you or your child will not have to stay in hospital after the surgery.

It is possible, if necessary, for the treatment to be complemented with the removal of the adenoids as well, by means of an adenoidectomy, therefore, the process will take approximately 40 minutes.

As for the duration of the postoperative period, the time you will have to stay following the medical indications and help the healing process to be completed correctly is between 10 - 15 days after the operation. So be patient and if it is your child, help them with all their ailments and consult with the ENT specialist to prescribe painkillers to reduce the discomfort.

Normally, after 15 days, recovery is complete and the results are optimal. You will no longer have to worry and throat infections and inflammation will no longer develop so easily or so frequently.

The cost of tonsillectomy surgery provided by Operarme includes everything you need to carry out the operation safely and effectively for you or your child, offering you an all-inclusive price for tonsil removal surgery for 1.890 €.

What is included in the price of tonsillectomy surgery?

Booking surgery through Operarme to carry out tonsillectomy treatment includes in its fixed price all the elements necessary to carry out the surgery successfully and safely for you or your child. Below you will find a breakdown of what is included:

• Booking and use of the operating theatre.
• Post-operative visit.
• Medical fees.
• Anaesthesiologist fees.
• Nursing team fees.
• Surgical material necessary for the operation.

If you or your child has problems caused by persistent inflammation and infection of the tonsils and you are thinking that the most appropriate solution is tonsillectomy treatment, you can request a free surgical assessment consultation with our ENT specialist, so that he or she can get to know you, familiarise themselves with your or your child's case and decide the best option to eliminate the problems caused by the tonsils once and for all.

Do you suffer from tonsil hypertrophy and need a solution now? 

You can request an immediate, free assessment appointment by clicking on the image below: