Adenoidectomy and Tonsillectomy: Procedure, Recovery and Cost

Repeated sore throats, a child who snores or breathes through the mouth, or ear infections that keep coming back can all point to the tonsils or adenoids. Removing them is one of the most common ENT operations. It is done for the right reasons in the right patients, and most people recover well.

What are tonsils and adenoids?

• Tonsils are two soft lumps on either side of the back of the throat. You can see them when you open your mouth wide.

• Adenoids sit high behind the nose, where you can't see them. They are largest in young children and usually shrink by the teenage years.

Both are part of the body's defence against germs in early childhood. In Hindi, tonsillectomy means tonsils nikalne ka operation, and adenoids are naak ke peeche ki gaanth.

When is surgery considered?

For tonsils (tonsillectomy)

• Repeated throat infections, usually 7 or more in one year, 5 a year for two years, or 3 a year for three years

• A collection of pus beside the tonsil (peritonsillar abscess) that keeps coming back

• Loud snoring with pauses in breathing at night (sleep apnoea)

• Trouble swallowing because the tonsils are very large

For adenoids (adenoidectomy)

• A blocked nose and mouth breathing that doesn't improve

• Snoring and restless sleep

• Repeated ear infections or fluid behind the eardrum, which can affect hearing

• Sinus infections that keep returning

Both may be removed in the same operation. Surgery is not the first step. Doctors usually try medicines, nasal sprays and watchful waiting first, unless there is a risk to breathing or sleep.

How the operation is done

Both operations are done under general anaesthesia, so the patient is fully asleep and feels nothing. The operation usually takes 20 to 45 minutes and there are no cuts on the face or neck. The surgeon works through the mouth.

• Conventional (cold steel) method: the tonsils are lifted out with instruments, and bleeding is controlled

• Coblation or diathermy: energy-based tools remove the tissue and seal the vessels. Adenoidectomy by coblation is a common choice.

• Microdebrider: used for adenoids, to remove tissue with a precise cutting tool

The method depends on the surgeon and the patient. No single method is right for everyone.

Recovery

• Many children go home the same day or the next day. Adults often stay one night.

• A sore throat and ear pain are expected. The ear pain is often pain travelling from the throat.

• A white or yellow coating forms where the tonsils were. It is normal healing, not infection. It falls off after 5 to 10 days.

• Children usually go back to school after 1 to 2 weeks. Adults often need about 2 weeks.

• Tonsil recovery is harder in adults than in children.

Eating and drinking

• Start with cool fluids, ice cream, curd, soft khichdi, mashed banana and soft rice

• Drink plenty of water. Dehydration slows recovery.

• Avoid hot, spicy, sharp or hard foods like chips, nuts and toast for about 2 weeks

• Give pain medicines as the surgeon prescribes. Ask before giving ibuprofen or aspirin.

Get help now: Go to the emergency room now if there is bleeding from the mouth or nose, you see bright red blood, or the person keeps swallowing and spitting blood. Bleeding can happen on the day of surgery, or about 5 to 10 days later when the coating falls off. Also get help for high fever, trouble breathing, or a child who won't drink and is not passing urine.

Risks

These operations are common and generally safe, but every operation has risks. They include bleeding, infection, pain that makes it hard to drink, dehydration, and rarely a problem with anaesthesia. Adenoids can grow back in a small number of children. Your surgeon will go through the risks with you.

What affects the cost

The cost depends on whether tonsils, adenoids or both are removed, the method used, the surgeon and anaesthetist, the hospital and room, whether it is a day-care stay or an overnight stay, tests, and medicines. Most health insurance policies cover tonsil and adenoid surgery when it is medically needed. Check the waiting period and room limits. For the cost of adenoid surgery or tonsil removal, ask for a written estimate that lists what is included. At Axten, the price is shared in writing after your consultation.

Questions to ask your ENT surgeon

• Is surgery really needed now, or can we wait?

• Will tonsils, adenoids or both be removed?

• Which method do you use, and why?

• Will we stay overnight?

• When can my child return to school?

Common questions

Will my child get ill more often without tonsils? No. Other parts of the immune system take over. Studies show no lasting harm to the body's defences.

Can tonsils or adenoids grow back? Tonsils rarely do if fully removed. Adenoids can regrow in a few children.

Is it painful? Yes, the throat is sore for about a week or more. Pain medicines, fluids and soft food help.

Is there an age limit? No fixed limit. The surgeon looks at the reasons, general health and anaesthesia safety.

Have questions or want to see a specialist? For appointment and queries, call 8156929292. AXTEN HOSPITALS - HONEST SURGERY, HONEST CARE.