The tonsils are lumps lymphoid tissue located on both side of the neck. There are various types of white blood cells in the tonsillar tissue and their functions are to trap and destroy the germs entering both respiratory and digestive systems. Dr. Nathita Chomchuen, our otolaryngologist (ear nose and throat doctor) at Bangkok Hospital Hua Hin, shares that tonsillitis is an inflammation of the tonsils which is caused by viruses or bacteria. When the infection occurs, it causes symptoms including fever, sore throat, painful swallowing, The infection also causes swelling of the lymph nodes around the neck areas and complications such as peritonsillar abscess. The treatments are symptomatic and depends on the severity of the condition which normally include antibiotics, sore throat medicines, antipyretic, anti-inflammatory drugs or in some cases, the patient may require operation to help drain pus. Tonsillectomy The doctor will consider tonsillectomy in the following cases:

1. Medication treatment is ineffective or the inflammation occurs several times a year interfering daily life (6 times per year, or 5 times per year for 2 consecutive years, or 3 times per year for 3 consecutive years)
2. Peritonsillar abscess which is a collection of pus around the tonsils. The tonsillectomy is often scheduled 1- 2 months after the recovery.
3. When enlarged tonsils causes degrees of obstruction causing snoring and / or sleep apnea
4. When the patient is suspected of having cancers of tonsils or lymph nodes in the neck. – The doctor will remove the tonsils through the mouth by general anesthesia. The patient is required to fast for at least 6 hours before surgery to prevent food aspiration during general anesthesia. – The patient will have ulcers after removing the tonsils on both sides of the throat. The pain will much less within a week and disappear in 2-4 weeks when the wounds heal completely. – After surgery, if there is no bleeding and patient can eat well. The doctor will remove the IV line and the patient can leave the hospital. The follow up appointment will be scheduled approximately 1 week after for the doctor to check the wounds and share the biopsy results.

Recommendation after tonsillectomy surgery

1. Patient may have a sore throat at the wounds on both sides of the neck, the wound may be swollen and lightly bleeding. In the beginning, it may be difficult to swallow food and only liquid food such as cold milk, yoghurt, ice cream can be managed. If there is no wound pain, the patient can eat soft food containing little fibers such as porridge and soft boiled rice.
2. Some patients may experience swollen pharyngeal walls causing breathing discomfort. Sleeping sleep with head elevated can help. In case of continuous swelling and difficulty breathing, the patient should see a doctor urgently.

What to avoid

1. Within the first week of surgery, the patient should avoid strong coughing, efforts to cough up phlegm out, deep teeth brushing, heavy exertion and heavy lifting as they may lead to bleeding.
2. In case of bleeding, lie down with your head elevated and put the cold water in your mouth for 10 minutes and alternate with application of cold compress to the neck area. If the bleeding does not stop, seek medical attention urgently.
3. One week after surgery, patient should avoid spicy food and avoid having large bites or hard food because it may scratch the surgical wounds and lead to infection or bleeding.

Complications related to the tonsillectomy Anesthesia Complications Some patients may have complications from general anesthesia and tracheal intubation such as sore throat, hoarse voice from the swollen vocal cords. If it happens, the symptoms will improve within 2 – 3 days. Surgical Complications

1. Bleeding from the surgical wound, patient should avoid spicy food, large bites or hard food.
2. Difficulty of breathing from swollen throat wall. The patient may need to be intubated after surgery for a while.
3. Eating less, after the surgery, patient will have sore throat and difficulty of swallowing food or saliva. This may cause weight loss or dehydration. There may also be a little blood in the saliva.

“Some people believe that tonsillectomy will reduce the body immunity leading to infection which is a wrong belief. Tonsillectomy does not impair the immunity of the body or the mouth. Lastly, the patient with tonsillitis should see a specialist for proper advice and treatments to avoid chronic and severe symptoms.” Dr. Nathita concluded. ************************************************************************** For more information and booking an appointment, please contact : Tel. 032-616-800 Call Center, Bangkok Hospital Hua Hin Tel: 032-616-880 (7.00 – 19.00 hrs.) Out-patient Department, ground floor Line : @bangkokhuahin or https://lin.ee/5tso2l0