Tonsillectomy Surgery

How the Procedure Works

A tonsillectomy is the surgical removal of the tonsils, glands in the throat that are meant to help fight infection. In some cases, the tonsils are large, or repeatedly become infected instead of fighting infection and must be removed. The tonsillectomy procedure is often combined with an adenoidectomy, which is the removal of an additional set of glands that are also in the throat.

A doctor checking the tonsils of his young patient
FatCamera / Getty Images

Tonsillectomies are most commonly performed on children, but adults do have the surgery, often when the tonsils are causing a breathing problem like sleep apnea.

Tonsillectomy Surgical Procedure

In most cases, a tonsillectomy is an outpatient procedure, which allows the patient to go home once they are fully awake from surgery. The procedure is performed under general anesthesia, so the patient is asleep through the surgery, which is usually completed in less than an hour.

Instead of the typical method of intubation, where a breathing tube is passed through the mouth into the airway, the patient is intubated nasally, with the tube inserted in the nose and down into the airway, keeping the mouth available for the surgical procedure.​

Once the patient is asleep, the surgery begins. An instrument is used to hold the mouth open, allowing the surgeon to work without the teeth in the way.

The tonsils are then cut away with a scalpel, a laser or a heated instrument. The bleeding is typically controlled by cauterizing the incision. If necessary, an adenoidectomy is also performed, using the same technique.

Once the tonsils and potentially the adenoids are removed and the bleeding is controlled, the surgery is over. The anesthesiologist stops the anesthesia and gives a drug to help the patient wake. When the patient is awake enough to breathe without assistance, the breathing tube is removed and the patient is taken to the PACU, or post-anesthesia care unit until they wake completely.

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  1. Stanford Children's Health, Lucile Packard Children's Hospital Stanford. Tonsillectomy and adenoidectomy.

  2. Cleveland Clinic. Tonsillectomy: procedure details. Updated March 6, 2019.

  3. Waheed El-Anwar M, AbdElhady M, Hussein A, Abdelgalel EF, Hosny S. Nasal intubation for adenotonsillectomy under general anesthesia. Journal of Otolaryngology: Research. 2018;(3)1:122.

  4. Edler AA, Mariano ER, Golianu B, Kuan C, Pentcheva K. An analysis of factors influencing postanesthesia recovery after pediatric ambulatory tonsillectomy and adenoidectomy. Anesth Analg. 2007;104(4):784-9. doi:10.1213/01.ane.0000258771.53068.09

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