What are Tonsils?

The glandular/lymphoid tissue that surrounds the back of the throat forms a “ring” that includes the tonsils. At the back of the mouth, on both sides, are the tonsils.


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What role do they play in our body system?

To combat germs that penetrate the nose, mouth, and throat, tonsils serve as a “policeman” and aid in the formation of antibodies. There is no evidence that this function will continue to be important after the age of three, but it is vital in young children up to that age.

Will my child suffer a loss of immunity after the removal of my tonsils?

The tonsils are only a very small part of our immune system. In the body, there are various lymph nodes that could serve as a defence mechanism. Several studies have revealed that children who have their tonsils and adenoids removed don’t lose any immunity to illnesses.

Children who have their tonsils removed do not, on average, have any more illnesses than children who “keep” their tonsils. In fact, these children will get fewer illnesses like strep throat after their tonsils are taken out.

The Examination

The primary methods used to examine tonsils are:

  • Medical history
    • Physical examination
    • X-rays/Endoscopy

What should my child expect at the Examination?

The doctor will ask about the child’s problems and examine the ear, nose, throat, head and neck areas. He will use a small lighted instrument to look into these areas.


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Children who are cooperative will have their tonsils checked using a flexible endoscope and a nasal optic examination (no pain). This process is carried out at the clinic. First, with a clear view of the auditory canal and the oral cavity, the nasal cavity and all of its structures up to the nasopharynx are assessed. The optic examination is typically painless and well-endured by children. A recording is typically done so that the photos may be reviewed.

The nasal optic examination for children who are uncooperative will be done using an x-ray.  This is useful for estimating the tonsils’ shape and size.


3 Common Causes of Tonsillitis:

Respiratory viruses – especially flu viruses and colds, could result in tonsillitis. Although they are not as serious as bacterial infections, it can occasionally be challenging to differentiate between a bacterial and viral infection.

Group A streptococcus – it is a common bacteria that cause throat infections in 1 in 5 patients, including adults. Although some people may not show any symptoms, they might still spread the infection. Strep throat may also be brought on by Group A streptococcus.

Infectious mononucleosis – caused by the Epstein Barr virus, can also produce tonsillitis symptoms, especially in young children.


Symptoms and Complications of Tonsillitis

The discomfort is usually felt in the throat, but occasionally it may also be felt in the ears because the throat and ears share the same nerves. Oftentimes, swallowing makes the pain worse. Little children might just refuse to eat rather than complain of a sore throat.

Other symptoms can include:

  • Sore throat
  • Snoring
  • Fever
  • Bad Breath


What problem does enlarged Tonsils caused?

Snoring, obstructive sleep apnea and throat breathing obstruction during sleep can all be caused by enlarged tonsils. When a child or adult briefly stops breathing during sleep, it is called obstructive sleep apnea. In many cases, a blockage in the airway is the main reason for sleep apnea.

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All About Tonsillectomy

Tonsil Removal Surgery Adults

When do you need a Tonsillectomy?

Tonsillectomy in Singapore is recommended when the tonsils become a liability. They become a liability when they become infected (tonsilitis) or when they grow too large in size (tonsillar hypertrophy).

If the following symptoms are observed:

  • recurrent bacterial tonsillitis
  • breathing problems caused by swollen tonsils
  • sleep apnea
  • bleeding on tonsils
  • tonsil cancer

Tonsillectomy would be an option to discuss with the doctor.

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Will you outgrow your tonsils?

Some of you might be wondering why the tonsils are removed if they are a crucial component of the immune system. Before the age of six, your immune system receives the majority of its early education. If your tonsils are so big that they literally prevent you from breathing at night, either now or even years from now, wouldn’t you agree that this is a more critical concern that needs to be addressed?

Moreover, doctors will claim that children will “grow out of it.” Admittedly, they will in the majority of cases. Still, there is ample evidence from all the most current research that before they “grow out of it,” there may be long-term effects, including a higher chance of developing obstructive sleep apnea, stroke, heart attack or heart disease in later stages of life.

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How do you prepare for a Tonsillectomy?

Your child must fast for six hours before the surgery. No food, water, or drinks is permitted. A younger child will have a shorter fasting period.
The doctor should be notified if the child has a fever the day before the surgery date because the tonsillectomy surgery might need to be postponed if the child is deemed unfit for it.

If the child has a history of bleeding disorders or has a family history of the condition, as well as any issues related to past anaesthetic events, it should be addressed to the doctor.

About The Surgery

How is the surgery done?

The tonsil removal surgery is done under general anaesthesia, and this procedure is usually done as a day procedure. There is no need to stay overnight in the hospital.

This surgery usually takes between 35 to 45 minutes and it is done through the oral cavity (mouth), and the is no incision will be made on the face.

What are the latest techniques for removing the tonsils (no pain method)?

Specialised instruments such as coblation and microdebrider are used to improve healing and reduce the side effect of pain after an inflamed tonsil or tonsil stone removal surgery.

How painful is a tonsillectomy?

The level of pain is no more than a tonsilitis attack. With the use of specialised surgical instruments and good painkiller medications, the level of pain is very manageable.



Recovery After a Tonsillectomy

What to expect right after the surgery?

The child may still be sleepy after surgery as he or she is still resting from the general anaesthetic, but this effect will pass after some time. He will thereafter be permitted to consume food and drinks. After surgery, ice cream and cold beverages are encouraged, and a soft diet is advised during recovery.

It is normal if there is a small amount of blood in the child’s sputum.

What are the things to take note after the surgery?

The child may suffer a sore throat and dry mouth for a few days following surgery, but these symptoms will gradually subside once the throat muscles return to normal. It is highly recommended that normal eating habits be resumed in order to stop debris from forming and to speed up the healing process. The child must take the prescribed painkiller to lessen any throat discomfort, and the full antibiotic treatment must be completed.

During the first few days of recovery, there may be a whitish coating at the tonsillar beds; this is a common symptom of a throat wound that is healing.

Is there any follow-up with the doctor post-surgery?

Post-surgery follow-up date will be given upon discharge from the hospital. Please do come for the appointment, as post-surgery follow-up care is important in preventing possible complications.

Frequently Asked Questions

Is it common for children to get a tonsillectomy?

Tonsillectomy in Singapore is a long-practised procedure that is still considered one of the most common surgeries for children.

Children tend to have large tonsils, but in some cases, they may lead to breathing difficulties. If you notice recurring symptoms in your child, it is best to consult an ENT specialist.

How painful is a tonsillectomy?

The level of pain is no more than a tonsilitis attack. With the use of specialised surgical instruments and good painkiller medications, the level of pain is very manageable.

Are there any diet restrictions after the surgery?

No, there is no post-surgery diet restriction, and a normal diet is highly recommended. The child must stay hydrated and follow a soft diet for a day or two after the tonsillectomy. Cold drinks and milk will soothe and ease the throat.

Can the patient talk after tonsillectomy?

After a tonsillectomy or tonsil stone removal surgery, you can talk as per normal. Keep your throat hydrated.

Is there anything the patient should avoid post-surgery?

During the first week post-surgery, it is encouraged that the patient should avoid contact with people suffering from coughs, colds or other infections. Contact with smoking individuals and crowded places is also not encouraged.

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