Ask a baby boomer if he or she still has tonsils, and you’ll find that many will say no. That’s because having your tonsils out was virtually a rite of passage for young school-age children of the 1950s and 1960s. In fact, it was often a family affair, with siblings going in together to have the surgery done.
Times changed. In the decades that followed, fewer and
fewer tonsillectomies were done, due in large part to the
development of stricter criteria for this type of surgery. The
pendulum is swinging back again, though, nudged by a
better understanding of how the tonsils can affect – or even
cause – sleep apnea, another important medical condition.
Fortunately for those requiring surgery, there is now a greatly
improved surgical procedure called coblation tonsillectomy.
Less Post-operative Pain, Faster Recovery
Coblation tonsillectomy involves the use of a saline solution
that drips onto the tonsils. As radiofrequency energy is
applied to the saline, it creates a ‘plasma field’ that gently
divides the tonsil from the surrounding tissue. Patients
come to the hospital the morning of surgery and return home
that same day. The surgery itself lasts only 15-20 minutes.
Tonsillectomies were traditionally performed with electrocautery, which uses a high-temperature electric arc to remove the tonsil. Although this technique was effective in removing the swollen and infected tonsils, healthy surrounding tissue was often damaged by the high heat.
This resulted in more post-operative pain and a significantly longer recovery time – often as long as two weeks. “Coblation tonsillectomy spares the surrounding tissue, so most patients can resume their normal diet and activities within a few days,” says Douglas Nadel, MD, a Doylestown Hospital otolaryngologist (ear, nose and throat doctor). “Children, especially, bounce back much more quickly with this procedure.”
Two Major Reasons for Tonsillectomy
According to Dr. Nadel, about half of the coblation tonsillectomies
performed are for chronic infection and half are
for sleep apnea caused by enlarged tonsils. “We now know
that sleep apnea – brief interruptions of breathing during
sleep – puts a strain on the heart and lungs and is
associated with daytime sleepiness, poor concentration,
irritability, and problems in school,” he says.
The growing awareness within the medical community, as well as among parents and educators, of the negative effects of sleep apnea and the role tonsils may play in this condition are making tonsillectomy a more common surgery today than it has been for a number of years. Fortunately, the kinder and gentler coblation technique is also making today’s tonsillectomy a lot more comfortable.
For more information about both tonsillitis and sleep apnea, visit www.dh.org, click on ‘Online Health Information’ at the top right of the page, then choose ‘Medical Conditions.”
Tonsillectomy, like any surgery, is considered only when non-surgical treatment hasn’t provided appropriate relief. A course of antibiotics is usually the first treatment doctors prescribe for a bacterial infection of the tonsils (tonsillitis).
For children and adults whose infection doesn’t keep recurring, this may be all that’s needed. However, for children and adults with recurrent infections of the tonsils or with serious sleep apnea, tonsillectomy can be extremely helpful.
