Tonsillitis

This page is for Tonsillitis in ADULTS

Click here for Tonsillitis in Children

What are the tonsils?

Tonsils are lumps of tissue at the back of the throat.

What is the function of the tonsils?

In children, tonsils are part of the body's "Early warning system". They help detect bugs in the throat. By adulthood, the tonsils have typically shrunken down and become mostly inactive.

What problems can occur in the Tonsils?

There are a few problems that may affect your tonsils:

1. The tonsils become too big causing snoring
2. The tonsils keep getting infected (recurrent tonsillitis)
3. You develop tonsil stones (small, white lumps that smell terrible and cause bad breath)
4. Cancer in a tonsil (very rare, increased risk with smoking and HPV)

What happens when tonsils become too big and cause snoring?

If the tonsils are very large, they can block your breathing passages at night causing snoring and sleep disturbance. In severe cases this can lead to Obstructive Sleep Apnoea (OSA) where you may temporarily stop breathing at night.

How are big tonsils with snoring and/or sleep disturbance treated?

When snoring and/or sleep disturbance is due to big tonsils, the treatment is to remove the tonsils. This is either through a tonsillectomy, or combined with palate surgery (modified-UPPP).

What is tonsillitis?

Tonsillitis is when the tonsils become infected.

What are the symptoms of tonsillitis?

When the tonsils are infected, the throat becomes sore and red. It becomes painful and difficult to swallow. The tonsils often swell up and become bigger. You will often have a fever and feel unwell.

How is tonsillitis treated?

See your GP if you think you have tonsillitis. Treatment usually consists of bed rest, plenty of fluids, pain relief and antibiotics.

What is recurrent tonsillitis?

Repeated episodes of tonsillitis, again and again, is called "Recurrent tonsillitis".

Is "Recurrent tonsillitis" bad?

Yes. Recurrent tonsillitis can affect your health. Multiple courses of antibiotics are not a good idea. Each time you becomes sick, you have to take time off.

How is recurrent tonsillitis treated?

Recurrent tonsillitis is treated by removing the tonsils (Tonsillectomy).

When should tonsillectomy be performed?

Official guidelines for children recommend that tonsillectomy should be considered when the child has had the following number of episodes:

• 7 episodes in the last 12 months OR
• 5 episodes per year in the past 2 years OR
• 3 episodes per year for the past 3 years

These are the general guidelines for children. Most adults will request tonsillectomy for themselves after much fewer episodes of tonsillitis. You are an individual and the decision as to when to undergo tonsillectomy is based on your individual circumstances, your choice and Dr Singh's recommendation.

What are tonsil stones?

Tonsil stones (Tonsilloliths) are small, white lumps that smell terrible and cause bad breath. Often, you will notice a sensation of something “stuck in the throat”. You will then cough up one or more stones. Some people are able to dig out multiple stones from the side of their tonsil using their finger or an implement.

How are tonsil stones treated?

Treatment of recurrent, long-term tonsil stones requires removal of the tonsils (Tonsillectomy). Other options for treatment include:

• Do nothing. You may keep getting tonsil stones.
• Improved oral hygiene. You can try better oral hygiene (tooth brushing, flossing, mouthwash), but this is usually not very effective.
• Stop mouth breathing. Mouth breathing at night often makes tonsil stones worse. Keeping the mouth closed at night by breathing through the nose may reduce tonsil stones. For more info on blocked nose, click here.
• Tonsillectomy. Dr Singh can remove your tonsils, which will prevent further tonsil stone formation.

Wait! The tonsils are part of the "Early warning system". If we remove the tonsils, will I get more infections?

No.

The tonsils are only 1 part of the "Early warning system" in young childhood. There is a whole ring of tissue around the throat and nose that performs exactly the same function as the tonsils. Removing the tonsils has no effect on the "Early warning system". Millions of tonsillectomy operations have been performed around the world and there is no increase in infections in individuals who have their tonsils removed.

How are the tonsils removed?

The tonsils are removed while you are asleep under a general anaesthetic. The tonsils are removed through the mouth - there are no cuts made on the outside.

There are many different ways to remove the tonsils. Older style ways to remove the tonsils include:

• Blunt dissection (gouging the tonsils out)
• Sharp dissection (Cutting the tonsils out with scissors or a scalpel)
• Diathermy/ bipolar/ coagulation/ electrical dissection (Using electricity at high temperature to burn the tonsils out)

Dr Singh uses "Coblation" or “BiZact” technology to remove the tonsils.

What is "Coblation" and “BiZact”?

Coblation and BiZact are modern technologies that remove the tonsils at low temperature. The potential benefits of these technologies include less bleeding and less pain.

Where is the operation performed?

Dr Singh performs tonsillectomy at Lakeview Private Hospital and Westmead Private Hospital. Lakeview Private Hospital is the first and only full-size hospital built and run entirely by specialist doctors, for the benefit of patients. Westmead Private Hospital is also one of Australia's leading private hospitals. It is part of the Westmead healthcare campus, the largest Hospital complex in the Southern Hemisphere. Westmead Private Hospital is also affiliated with the University of Sydney Faculty of Medicine, Australia's oldest and largest Medical School.

Are there any alternatives to surgery?

Yes. Tonsillectomy is an "Elective" procedure, meaning it is your choice to have the operation performed. Alternatives to surgery include:

• Do nothing. You may keep getting tonsillitis/ keep snoring/ keep getting tonsil stones.
• Long-term antibiotics. Sometimes, a long course of antibiotics for many weeks or months may reduce the risk of recurrent tonsillitis.

Are there any risks to surgery?

Yes. Everything we do in life has risks. Even something as simple as crossing the street has risks...but we still cross the street. Dr Singh will explain the risks of your operation and provide you with an information pamphlet that explains the risks in detail. If you have any questions about risks, ask Dr Singh during your consultation.

What should I do next?

See your GP if you think you have big tonsils with snoring and sleep disturbance, recurrent tonsillitis or tonsil stones. Ask your GP for a referral to see Dr Singh and call us for an appointment.