Tonsillectomy in adults and children

Written by: Professor Paul Chatrath
Published: | Updated: 03/05/2019
Edited by: Nicholas Howley

When is a tonsillectomy necessary? How does it work? Does the procedure differ between adults and children? We spoke to distinguished London ear, nose and throat surgeon Mr Paul Chatrath to find out the answers:

What is a tonsillectomy?

The tonsils are lymph glands situated at the back of the throat. They are part of the immune system and therefore help to fight infection. A tonsillectomy is an operation to remove the tonsils.

When is a tonsillectomy necessary?

Acute tonsillitis occurs when the tonsils become infected. This usually requires treatment in the form of antibiotics and pain relief.

If the tonsillitis does not settle and becomes chronic, or if the attacks of acute tonsillitis occur many times a year, then it may be necessary to remove the tonsils to prevent the problem from returning.

Is tonsil removal a big surgery?

Surgery to remove the tonsils (tonsillectomy) is generally a straightforward operation, almost always undertaken as a day case procedure under a general anaesthetic.

The risks include:

  • pain during the recovery period
  • the possibility of infection
  • bleeding in some cases
  • in rare cases, taste disturbance

However, most people do not suffer these consequences.

What happens during a tonsillectomy?

After you have been given a general anaesthetic to put you to sleep, you will be taken to the operating theatre where the final preoperative checks will be carried out. Then the operation will commence.

There are several different methods used to remove the tonsils. The traditional techniques include using surgical instruments and/or diathermy (heat generated by an electrical current), although in recent years coblation radiofrequency tonsillectomy has also gained popularity as it involves using a less invasive treatment at a much lower temperature. Depending on how the coblation technique is used, this can lead to less postoperative pain and a faster recovery.

Is an adult tonsillectomy the same as a tonsillectomy in children?

In principle the actual surgery differs little between adults and children, in that the same types of surgical techniques can be used to remove the tonsils.

The main difference is that adult tonsils tend to be more inflamed and scarred than those in children, mainly due to the increased number of attacks of tonsillitis that adults have had compared with children. This increases the amount of scarring that occurs after the surgery, which in turn increases the pain and duration of recovery that adults experience.

The success rates are however very much the same between adult and paediatric tonsillectomy.

Learn more about different types of tonsillectomy

How long is the recovery post-tonsillectomy?

After the operation, you will go back to the ward where you will be monitored for 4-6 hours, then you will be allowed to go home.

It is important to take your painkillers exactly as prescribed, as this will help you to eat and drink regularly. Eating as normal a diet as possible is crucial as this helps to keep the back of the throat clean and to avoid the build-up of debris, which in turn reduces the risk of infection and bleeding. It is quite normal for the recovery to be quite painful, and for the pain to get worse over the course of 5-10 days before it gets better again.

The total recovery time is usually complete within 2 weeks, often a little quicker in children and if the coblation technique has been used.

By Professor Paul Chatrath
Otolaryngology / ENT

Prof Paul Chatrath is a skilled and distinguished London ear, nose and throat surgeon, specialising in rhinology and facial plastic surgery. With over 20 years of experience, he provides a wide range of ENT, head and neck and plastic surgery procedures to both adults and children from his private practices in London, Brentwood and Buckhurst. 

Prof Paul Chatrath completed his premedical degree at the University of Cambridge in 1992 and subsequent clinical training, continuing on to obtain his MBBS degree from the London Hospital Medical College, with distinctions in 3 subjects and was granted Proxime Accessit to the University of London Gold Medal. He finalised his higher surgical training in ENT surgery in London and was granted a Certificate of Completion of Training in ENT Surgery, upon passing the final FRCS examination. Thanks to his research into the role of surface brushings of the larynx in discriminating between cancerous areas and benign (non-cancerous) lesions, Prof Chatrath was awarded an MD high research degree with the University of London. He also completed further training in specialist units in Chicago and Amsterdam after earning the Lionel College & New York Travelling Fellowships by the Royal College of Surgeons, and travel grants by the Royal Society of Medicine and the Journal of Laryngology & Otology.  

Prof Chatrath has performed over 1000 rhinoplasty operations and over 1500 paediatric ENT procedures including tonsillectomy, adenoidectomy and the insertion of grommets. He has also been a leader in pioneering nasal and sinus operations, like balloon sinuplasty for the non-invasive management of sinus disease. Although he manages all general ENT conditions, he is interested in particular in nose and sinus problems, allergy, cosmetic deformities, children´s ENT disorders, voice problems and snoring.  He practices in 150 Harley Street, Spire Hartswood Hospital, Spire London East Hospital, The Holly Hospital, Hospital of Sain John and Saint Elizabeth and the London Clinic.

Alongside his clinical practice, Prof Chatrath is also active in ENT teaching and research. He holds the position of Honorary Senior Lecturer at the Anglia Ruskin University in Chelmsford. He is also Professor of Rhinology at Canterbury Christ Church University, Kent, here he leads a module in rhinology and facial plastic surgery for the MCh (ENT), postgraduate study in surgery. His research focuses on the clinical assessment of patients with nasal obstruction. He has published over 40 papers in peer reviewed journals and has also contributed chapters to books.  

Prof Chatrath aims to give his patients the best care, in a professional yet sympathetic manner. He understands the importance of communication with his patients both before and after surgical procedures, answering queries actively throughout the process. 

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