How will I know if I need a tonsillectomy?

Doctor's Answer

Thank you for your question. Tonsils are two oval-shaped soft tissue sitting at the back of your throat (see picture below).

tonsil Singapore

They are part of your immune system. Their role in your body's immunity against infection is negligible as other immune organs such as your lymphatic system, liver and spleen are the main players in your immune system.

I shall answer both your questions as follows:

a) How do I know if I need to remove my tonsils?

I often tell my patients that the tonsils are very much like the appendix. If they do not give you any problems, you leave them alone.

It doesn't mean that if your grandmother had her tonsils removed, you are more likely to or need to have your tonsils removed.

However, in some patients, the tonsils can be problematic. I do recommend tonsillectomy (surgical removal of tonsils under general anaesthesia) in these conditions:

1. Frequent or recurrent tonsillitis - If you get frequent tonsil infections (usually painful sore throat, fever and painful swallowing requiring oral antibiotics) resulting in hospitalisation, significant time off work or significant impairment in quality of life, you may consider having your tonsils removed. Most ENT surgeons would recommend tonsillectomy if you have significant acute tonsillitis more than 3 times a year.

2. Snoring or obstructive sleep apnoea (OSA) - If your tonsils are very big such that they cause snoring or OSA (a condition in which a person "chokes or stop breathing momentarily" during sleep), your ENT Specialist may recommend removal of your tonsils to create more space in your upper airway.

3. Suspected cancer - If there is a suspicious growth on your tonsil or if one of your tonsil is way bigger than the other (asymmetrically enlarged tonsil), you may need a tonsillectomy to rule out cancer.

4. Other problems with your tonsils – Sometimes a tonsil is removed because a fish bone is stuck and buried within it or as part of surgical access to other areas in the throat and neck region.

b) Are there any adverse effects if I have them removed?

As mentioned above, the tonsils play a very small role in the immune system of your body. There are numerous studies that have shown that removal of the tonsils does not decrease your immunity or make you more prone to infections.

However, like all surgeries, there are potential risks involved in the removal of tonsils. The most common complication of tonsillectomy is bleeding (~5-10%).

The majority of bleeding can be stopped in the clinic. Occasionally, the bleeding may require surgical intervention.

Rarer complications from tonsillectomy include infection and injuries to the lips, teeth or gums during surgery (during retraction of the tongue and mouth to expose the tonsils). The operation is done through the mouth and there will be no external cuts on the neck.

Hope this helps, and all the best!

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