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Tonsil Surgery in London for Adults and Children

Tonsillectomy is one of the most established ENT operations, for both adults and children. It is considered when the tonsils are causing more harm than good, whether through repeated bouts of tonsillitis, disturbed breathing at night, or a serious infection such as a quinsy. Our consultants treat adults and children alike, and will only recommend surgery when it is genuinely the right step.
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tonsil
Surgery & Treatment

What are the tonsils and what do they do?

The tonsils are two small glands at the back of the throat, one on each side. In young children they help fight germs. After the age of about three the tonsils become less important to the immune system and usually shrink, and the body continues to fight infection perfectly well without them. This is why removing them, when they are causing problems, does not leave you more prone to illness.

When is a tonsillectomy needed?

A tonsillectomy is only recommended when the tonsils are doing more harm than good. The main reasons, in adults and children, are:

  • Recurrent tonsillitis, meaning frequent throat infections needing repeated courses of antibiotics and time off work or school
  • Sleep-disordered breathing, where large tonsils block the airway, causing heavy snoring with brief pauses in breathing during sleep
  • Quinsy, an abscess that forms beside the tonsil after infection. It is very unpleasant, and people who have had one often choose surgery to avoid a recurrence
  • Difficulty swallowing, or persistently enlarged tonsils affecting eating or speech
  • Suspicion of anything more serious in an enlarged tonsil, particularly one that is larger on one side, which is assessed carefully

The threshold for surgery is a clinical judgement. Your consultant will weigh how often infections occur, how severe they are, and the effect on daily life, and will be honest if watchful waiting is the better course.

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The condition is the same, but the picture differs. In children, enlarged tonsils and adenoids are a common cause of disturbed sleep, and the adenoids are often removed at the same time. In adults, recurrent tonsillitis and quinsy are more often the reason for surgery, and recovery tends to be a little more uncomfortable and slightly slower. We tailor the assessment and the aftercare advice to the individual.
A tonsillectomy is carried out under general anaesthetic, so you or your child will be asleep throughout. The tonsils are removed through the mouth, with no cuts on the outside of the skin, the bleeding is controlled, and you are woken in recovery. The operation itself usually takes around thirty minutes.
Where large tonsils and adenoids are disturbing a child’s sleep, the adenoids may be removed in the same procedure. Your consultant will explain if this is planned.
Plan for around two weeks off work or school. Let us know if you or your child has a chest infection or active tonsillitis close to the admission date, as it may be safer to postpone. It is very important to tell us about any unusual bleeding or bruising, or any family history of bleeding problems. Also mention any loose, capped or crowned teeth, as there is a very small chance of damage to a tooth during the anaesthetic and surgery.

Recovery follows a familiar pattern, though it asks for patience:

  • A sore throat for around ten days, which can spread to the ears. Ear pain is normal and does not mean an ear infection, because the throat and ears share nerves.
  • Take painkillers regularly, ideally around half an hour before meals for at least the first week. Do not use aspirin, as it can increase bleeding.
  • Eat normal food. It sounds counterintuitive, but eating helps the throat heal and actually eases the pain. Drink plenty and stick to bland, non-spicy food.
  • The throat will look white while it heals, which is normal. Small dissolvable threads used during surgery may appear and fall out on their own.
  • Both adults and children usually need ten to fourteen days off work or school. Rest at home, away from crowds and smoky places, and avoid people with coughs and colds.
A throat infection can occasionally follow surgery, often when someone has not been eating properly. A fever and a bad smell from the throat are the signs, so contact your GP or the hospital for advice if that happens.
Tonsillectomy is very safe, but as with any operation there are small risks:
  • Bleeding, which is the main risk. It can happen during surgery or in the days afterwards, and rarely needs a second operation to stop it. Adults have a slightly higher risk of bleeding than children.
  • A small chance of damage to a tooth, particularly one that is loose, capped or crowned
  • Throat infection after surgery
  • The usual risks of a general anaesthetic, which your anaesthetist will discuss with you
Small dark or brown flecks in your saliva, or slightly pink-tinged spit, are common in the first week or two as the throat heals. Keep eating and drinking normally.
Get urgent medical help, at your nearest A&E if you:
  • Spit out more than a teaspoon of fresh red blood, or keep spitting streaks of fresh blood
  • Cough up or vomit blood or blood clots
  • (Children) are swallowing repeatedly, vomit dark blood, or look pale or drowsy

Frequently asked questions

How long does it take to recover from a tonsillectomy?
Most adults and children need ten to fourteen days off work or school. The throat is sore for around ten days and eases gradually. Eating normally and taking painkillers on schedule genuinely speeds things up.
The operation is the same, but adults tend to have a slightly more uncomfortable recovery and a slightly higher bleeding risk than children. It remains a safe, routine procedure.
No. After early childhood the tonsils play only a minor role in immunity, and the rest of the immune system continues to protect you normally.
When large tonsils and adenoids are together disturbing a child’s sleep or breathing, removing both in one operation deals with the whole problem and avoids a second anaesthetic.
A quinsy is an abscess that forms next to a tonsil after infection. It is painful and needs prompt treatment, and having had one is a common reason adults choose to have their tonsils removed.
It is generally treated as a functional operation, so many policies cover it. Cover and pre-authorisation vary by insurer and policy, so check with your provider before booking.
For adults, tonsil surgery is almost always performed as a day case, meaning you can usually go home on the day of your operation. We will only discharge you when you are eating and drinking and feel well enough to go home.