What is a tonsillectomy?

- [Voiceover] A tonsillectomy is removal of the tonsils. In fact, the name is actually very straightforward. - ectomy is a Latin suffix, meaning removal. So, a tonsillectomy is removal of the tonsils. Now, when we refer to the tonsils, we're specifically talking about the palatine tonsils, which, in this open-mouth view right here, you can see in the back of the mouth, just before we get into the back of the throat. They kind of hide back here. I have them colored in this purplish-pink color, but they're actually the same color as the rest of the mouth. Actually, there's two sets of tonsils. There's these, right here, that are visible in the mouth. There's also tonsils that can be seen through the nasal passage. They're out of direct view from the mouth. When we refer to a tonsillectomy, it's these tonsils, the visible ones, that we're talking about. These are called the palatine tonsils. They're called the palatine tonsils because they're somewhat related to the roof of the mouth. The roof of the mouth, of course, is also known as the palate. But, if a tonsillectomy is removal of these tonsils, what is removal of these tonsils? These are actually referred to as the adenoids. They have another name, known as the pharyngeal tonsils, but they're most commonly referred to as the adenoids. In fact, the removal of the adenoids is known as an adenoidectomy. Commonly, many patients get both the tonsils and the adenoids removed. These are actually two procedures done at the same time, a tonsillectomy and an adenoidectomy. Wait a second. You might actually be asking yourself, "Well, aren't my tonsils important? "Why would I want to remove them?" Sure, the tonsils are actually a fairly important organ. However, they're only important when we're developing, when we're very young. When we're children, the tonsils are actually fairly large. Their purpose is to act like little traps, so when bacteria, or viruses, or any sort of microbe gets into the mouth, or potentially through the nasal passage, then the tonsils act as a first line of defense. Tonsils are very vascular structures, meaning that they have a lot of blood vessels going to them. They also have a lot of white blood cells in them. This is important because if bacteria or viruses get trapped on the surface of the tonsils, then the white blood cells can respond accordingly. They're particularly important when we're young, as I said before, because our immune system is still developing. As we get older, the tonsils actually will shrink up, and shrivel to a smaller size. They may actually shrink to become barely visible near the roof of the mouth. I like to think this is because when we're young, we're still looking for many different types of bugs. But, once we're older, we've already been exposed to all these different bugs, and these different microbes. So, we no longer need the tonsils to inform the rest of the immune system to get prepared for this bug, because our body has already prepared in the past, and fought off an infection similar to the one that's now being presented. Removal of the tonsils is not the worst thing in the world. There are actually a lot of really good reasons that the tonsils should be removed. For example, some patients get tonsils that are infected, over, and over, and over again. This is chronic tonsillitis, chronic inflammation of the tonsils. Patients who get frequent tonsillitis, frequent infections, should actually have them removed. In fact, frequent infections may mean that the tonsils have become colonized by a microbe. Thus, the removal can stop these frequent infections. Frequent infections is one. Along the same lines, development of an abscess near the tonsils can be a reason for removal. An abscess is a fluid-filled pocket, and it's usually filled with bacteria and really nasty stuff. If it's next to the tonsils, it's called a peritonsillar abscess. These abscesses can be dangerous, and can lead to more severe illnesses, such as sepsis. Sometimes, they can be drained without removing the tonsils, but many times, this is not possible, so health practitioners opt to remove the tonsils. Really, a final reason, and it's kind of an umbrella reason, is if patients are having difficulty breathing, or difficulty eating, the tonsils might be removed. The idea is the tonsils may be obstructing the food, or obstructing proper breathing. For example, if you look at these adenoids, they might swell up to sizes that are just way too big, and obstruct the flow of air through the nasal passage. Maybe when patients lie flat, they can't breathe air in as well. This sometimes leads to issues, such as obstructive sleep apnea, difficultly breathing while sleeping. Some patients who have difficulty breathing may have the adenoids and the tonsils removed. Now, after the surgery, people often wonder, "When can I actually eat? "When can I have that nice, juicy burger again? "Or, maybe a delicious salad, or grilled chicken." Well, it really depends on what the health practitioner or the surgeon says. But, generally it's about two weeks before a patient makes full recovery. Maybe 10 days to two weeks. Patients who actually have a tonsillectomy, or adenoidectomy, often really don't care about food right away. Oftentimes, the throat may be painful or sore, or they may have jaw pain, or pain anywhere along where the surgery was. Patients may also have ear pain, too. That's because the connection between the nasal passage to the ear, the auditory canal, is right next to where the adenoids are. It's right about here. So, patients may experience throat pain, jaw pain, ear pain, neck pain, headache, any sort of symptom that might be related to the head. All of these symptoms are normal after surgery. Patients are encouraged to take pain killers, because patients may be in a good amount of pain after surgery. This is all normal. Having this pain is normal. However, if patients develop difficulty breathing, that's a very serious symptom. If a patient develops difficulty breathing, it may be a sign that the throat is swelling up, and swelling more than it should. Since we all need air to breathe, it's important to contact a health practitioner immediately. Otherwise, the throat may start to get so swollen that it closes and makes breathing impossible. Another major complication that can occur is bleeding. Because these tonsils are so vascular, or in other words, they have a large blood supply to them, bleeding may occur after the surgery. A certain amount of bleeding is okay, but if bleeding becomes active, and just doesn't seem to stop, that's a complication that should also be mentioned to a health practitioner. With that in mind, it's actually important not to eat anything that's red. Eating something, like a cup of red Jell-O, or a delicious watermelon ... Even though these foods are soft and easier to eat, they should be avoided because they are red, and may be mistaken for blood if a patient starts vomiting. Patients should avoid anything red. They need to avoid solid food. They should avoid anything that's very citrusy, spicy, or hot. That glass of orange juice, or that bottle of hot sauce, should be avoided. When I say hot, I don't mean just spicy food. Hot beverages should actually be avoided, too. All of these foods should be avoided. Again, if these directions are followed, patients are generally expected to recover two weeks after the surgery. Again, always check with the health practitioner, or surgeon, that's doing the surgery, and follow their directions.