The Risks Of A Tonsillectomy

by William Jacobson | March 3rd, 2015

Tonsillectomies are surgical procedures that have been routinely performed in the United States for many years. The procedure involves the removal or partial removal of the tonsils from the throat. Common reasons why a tonsillectomy might be necessary include:

  • Repeated tonsillitis
  • Frequent middle ear infections
  • Abscess in the area of the tonsil
  • Obstructive sleep apnea (disturbed breathing pattern during sleep)

Before the procedure, the patient and family should discuss with the surgeon whether an intra capsular (partial) tonsillectomy or a complete tonsillectomy is indicated. In a partial tonsillectomy, a portion of the tonsil is left in place to protect the throat muscles. The recovery is often faster because less tissue is removed. There remains a small chance that the tonsil tissue can regenerate or become infected and require additional surgery. Most surgeons prefer the complete removal of the tonsils as opposed to a partial tonsillectomy.

Tonsillectomy risks are relatively low and there is typically a favorable outcome. But, much like any surgical procedure, tonsillectomies are not without risks. The procedure is usually done under general anesthesia, a form of sedation involving its own risks, which vary depending on the patient’s overall health. Bleeding, or hemorrhaging, can also occur during, or after, a tonsillectomy. When the tonsils are removed, it is necessary for the surgeon to dissect small blood vessels in the area of the tonsil bed. The bleeding will commonly seal itself. When it doesn’t, the surgeon may cauterize the vessel in order to close it off and prevent further bleeding. In rare cases, a stitch is necessary.

Bleeding can occur not only during the tonsillectomy but after the procedure is completed. It is not uncommon for the patient to have some bleeding within the week following the procedure caused by a blood clot becoming detached.  In some cases, a blood vessel may have been unknowingly traumatized during the tonsillectomy, later rupturing.

In rare cases, the blood loss can be severe enough to require a blood transfusion. On extremely rare occasions, excessive bleeding can result in severe injury, or death. These extreme complications of a tonsillectomy occur more commonly when the patient has an underlying bleeding disorder or a congenital anomaly (also known as a birth defect). For example, there may be a blood vessel larger than expected in the area of the tonsil. Generally, the surgeon will inspect the area for the presence of a large, throbbing vessel prior to the tonsillectomy.

The patient should inform the surgeon of any personal history of bleeding disorders, or whether anyone in the family has a history of bleeding disorders. Any potential risks related to anesthesia such as impaired breathing or heart issues should also be discussed with the surgeon or anesthesiologist. If the patient has any questions, the benefits and risks of a tonsillectomy can be reviewed with the surgeon. A complete discussion of the tonsillectomy, along with full disclosure of any potential risks for complications, generally leads to a safe and effective procedure.

Source for common reasons for tonsillectomy –
http://www.nlm.nih.gov/medlineplus/tutorials/tonsillectomyadenoidectomy/ol049105.pdf