Tonsillectomy

Description:
Tonsil glands serve as agents against infections. However, in some people, particularly in children with larger tonsils, these glands can perform less efficiently and cause frequent throat and ear infections or obstruct breathing. In these cases, surgery to remove the tonsils is of benefit. Under general anesthesia, the ear-nose-throat (ENT) surgeon holds the mouth open and pulls the tongue forward to reveal the tonsils. The tonsils are pulled away from the back of the throat and then removed by being cut away. Bleeding is controlled, and often the cut heals naturally without stitches.

Indications:
Tonsillectomy is advisable when tonsillitis attacks are so frequent or severe that they affect a child's general health or interfere with school, hearing, or breathing. However, tonsillectomies are thought to be done more often than necessary, so a second opinion should be obtained when there is any doubt.

Specifically, the guidelines for surgery are:
  • 5 or more episodes of tonsillitis in one year, or
  • 3 or more episodes per year over a 2-year period, or
  • severe tonsillitis, or
  • tonsillitis that is not responding to antibiotics

Tonsillectomy is advised if the tonsils are enlarged and obstructing access to the adenoid during an adenoidectomy operation, or the physician suspects the presence of a tonsil tumor .

What to Expect After:
The surgery clears problems immediately in most cases. After surgery, the number of throat infections is reduced but not completely eliminated.

Convalescence:
Tonsillectomy is usually done on an outpatient basis, with the patient returning home the same day as the surgery. Only rarely are patients observed overnight in the hospital and return home the day after the surgery. Complete recovery can take 2 weeks. Expect some throat and ear pain in the first days following surgery. The use of ice-packs to relieve pain may be used, although sucking on an ice cube or ice cream may provide adequate comfort. In addition, pain-relief medication may be prescribed. During recovery, it is recommended to eat soft, easy-to-swallow food and to drink a lot of cold fluids. The use of humidifier at home can also bring some comfort. Your child may experience alternating "good and "bad days for 2 weeks after surgery. It is a good idea to keep your child away from crowds or ill people for 7 days, since the throat is highly susceptible to infections during this period.

Risks:
In addition to the risks associated with surgery under general anesthesia, in rare instances, postsurgical bleeding can go unnoticed and cause serious consequences. Frequent swallowing may be a sign of bleeding from tonsils. Other risks include injury to the uvula (soft palate).

Cost:
The costs of any surgery varies significantly between surgeons, medical facilities, and regions of the country. Patients who are younger, sicker, or need more extensive surgery will require more intensive and expensive treatment.

We have separated charges you can anticipate into five parts: 1) the surgeon's fee, 2) the anesthesiologist's fee, 3) the hospital charges, which includes nursing care and the operating room, 4) the medications, and 5) additional charges.

1. Surgeon's fee: averages $500
2. Anesthesiologist's fee: averages $350 to $400 per hour
3. Hospital charges: basic rate averages $1,500 to $1,800 per day
4. Medication charges: $200 to $400
5. Additional charges: assisting surgeon, treatment of complications, diagnostic procedures (such as blood or Xray exams), medical supplies, or equipment use.

The approximate cost for a tonsillectomy averages $3,000.

Insurance coverage for surgery expenses depends on many factors and should be explored for each individual instance.


A cross-section illustration of the mouth, nasal cavity, and throat. The nasal passages are also visible.



Tonsillectomy is a frequently performed surgery in which the tonsils (and occasionally adenoids) are removed. This is usually done if there are verified repeat episodes of streptococcal infection, obstruction of the airway or excessive snoring, sleep apnea (breathing stops when sleeping), or other more rare conditions. The number of tonsillectomies has decreased during the last 10 years as the indications have been better defined.