A tonsillectomy is a surgical procedure to remove the tonsils. Tonsillectomies are performed for a variety of reasons with two of the most common being chronic tonsillitis and tonsillar hypertrophy (enlarged tonsils).1 Tonsillectomy is one of the most common surgical procedures performed in the United States.2 Tonsillectomies are a relatively quick procedure, and most patients can go home the same day.
The tonsils are two round masses of lymphatic tissue located on each side of the throat.1 As part of our immune system, tonsils help fight infection but can sometimes become infected.1 Infection of the tonsils is called tonsillitis.
Tonsillectomies are commonly performed due to tonsillar hypertrophy or tonsillitis. Tonsillar hypertrophy is the term used to describe unusually enlarged tonsils. Tonsillar hypertrophy can be a chronic or temporary condition, caused by a number of different factors including infection.1 Chronic hypertrophy can sometimes interfere with normal breathing, nasal sinusdrainage, sleeping, swallowing and speaking.1 Tonsillitis is the term used to describe repeated cases of tonsillar infection. A few cases of tonsillitis do not necessarily warrant a tonsillectomy.
Before a tonsillectomy is recommended, doctors usually prescribe antibiotic therapy to treat tonsillitis. If the frequency of tonsillitis is not lessened by antibiotics, doctors may recommend a tonsillectomy.1
There are several ways to perform a tonsillectomy. COBLATION◊ technology uses low-temperature radiofrequency energy with saline to create a plasma field. The plasma field is contained at the tip of the device. COBLATION technology dissolves tissue molecule by molecule, resulting in a precise removal of targeted tissue. By generating significantly lower temperatures than electrosurgery, the COBLATION process minimizes damage to surrounding healthy tissue.3
Another method is electrosurgery. Electrosurgery uses electrical energy to remove the tonsils. This electrical energy generates very high heat to rupture cells and vaporize tonsil tissue. This sometimes causes significant damage such as burning and charring at the surgical site.3
Upon arrival to the surgery center or hospital, patients will meet with nurses and anesthesiologists to review medical history. General anesthesia is used to put patients to sleep during a tonsillectomy. The procedure usually lasts about thirty to forty-five minutes.4 After the procedure, patients will be taken to a recovery room and monitored closely.
Tonsillectomy is an outpatient procedure which usually means patients can go home after their surgery, the same day. However, if there are complications, or if the surgery is performed on a young child, an overnight stay may be necessary. Surgeons should provide detailed preoperative and postoperative care lists to help answer questions.
Patients' recovery experiences depend on a variety of factors such as their age, the technology used to perform the tonsillectomy, and how closely patients follow their doctor's instruction. Depending on these factors, some patients may recover more rapidly; some patients' recovery time may last two weeks.4 The most common post-surgery symptom is a sore throat. Pain in the neck, jaws, or ears may also occur for a short time. Bleeding from the surgical site should not happen. If such bleeding occurs, contact the doctor immediately.1
No matter how statistically safe a procedure has proven to be, every surgery has risks. Post Tonsillectomy Hemorrhage (PTH) is a potentially serious complication that has been reported in literature for both adult and pediatric patients. It is reported to occur following use of COBLATION devices as well as following the use of other surgical devices and methods. Before making any surgical decision, you should speak with your doctor about any potential risks.
COBLATION wands are contraindicated for use in patients with cardiac pacemakers or other electronic device implants.
* Compared to monopolar dissection, based on analysis of eight randomized clinical trials.
Harley Jr., Earl H., John T., Mike and Hanson, Beate. Coblation Dissection Versus Monopolar Dissection - A systematic Review and Meta-Analysis. 2016; Data on file with Smith & Nephew, PN 91999 Rev A.
Woloszko, Jean, and Gilbride, Charles. Coblation Technology: Plasma Mediated Ablation for Otolaryngology Applications. Proceedings of SPIE. 2000, Vol. 3907.