Third tonsil surgery: when and why?
Adenoidectomy, or removal of the third tonsil, is one of the most common surgical procedures in otorhinolaryngology. It is mostly done in children, but due to certain indications, the procedure is also performed in adulthood.
The third tonsil in medicine is known as the adenoid vegetation. It develops on the roof of the epipharynx (nasal part of the pharynx) and is exposed to particles of inhaled air. It is located at the mouth of the Eustachian tube, so frequent inflammation of the third tonsil can consequently cause otitis media and hearing problems in children and adults.
Adenoidectomy is recommended in adults when a person has trouble sleeping, difficulty breathing, snoring, or recurrent otitis media due to enlarged adenoid vegetation.
The third tonsil is present at birth, it grows until the age of 5 to 7 years. By school age, the third tonsil gradually shrinks, and in the teenage years it is usually already so small that it rarely causes problems.
If exposure to microorganisms causes inflammation and enlargement of the third tonsil, it can significantly affect the passage of air through the nose and cause inflammation of the sinuses, nose, throat and ear.
People with an enlarged third tonsil in most cases present symptoms of nasal speech, snoring, mouth breathing.
In addition, it can occur: impaired hearing, nasal discharge, cough, impaired speech and headache.
Enlargement of the third tonsil can cause repeated and long-term inflammation of the ear, throat, nose and sinuses. Research shows that adenoidectomy is an effective therapeutic option in preventing recurrent otitis media.
In people with chronic sinusitis, the third tonsil represents a potential reservoir of bacterial infection. Removal of the third tonsil helps to eliminate the signs and symptoms of long-term inflammation of the ear, nose and sinuses.
Increased adenoid vegetation can affect airway patency, cause nasal congestion, mouth breathing, and snoring. Given the symptoms of breathing difficulties, an enlarged third tonsil often leads to difficulty sleeping and even to the cessation of breathing during sleep – apnea.
If, despite antibiotic therapy, inflammation persists, the option of surgical treatment should be considered. Removal of the third tonsil improves the general health of the patient, prevents recurrent inflammation and contributes to a better quality of life.
Most countries have guidelines for indicating adenoidectomy and tonsillectomy. In Croatia, this was done by the Interdisciplinary Section for the Control of Antibiotic Resistance (ISKRA) of the Ministry of Health and Social Welfare of the Republic of Croatia.
Indications for third tonsil surgery:
Third tonsil surgery is a relatively simple surgical procedure that is successfully performed in adulthood without much risk. The procedure itself lasts for a relatively short time and does not require long hospital treatment after it.
After the procedure, you can go to home care on the same day , adhering to the general hygiene and nutritional guidelines that you will receive from our staff.
Before surgery on the third tonsil, it is definitely necessary to have an examination by an otorhinolaryngologist to determine the condition and size of the third tonsil.
Due to the anatomical position of adenoid vegetation, it is not possible to see them during clinical examination, so for diagnostic purposes, it is necessary to perform an endoscopic examination of the nose, the so-called fiberendoscopy.
In addition to the aforementioned tests, additional laboratory tests of blood and urine and an examination by an anesthesiologist must be performed before the operation itself.
If you have allergies to certain medications or use regular therapy for certain diseases, be sure to mention this during the conversation with the anesthesiologist to prevent the possible occurrence of side effects related to anesthesia.
Adenoid removal is treated in practice as an outpatient procedure. The use of modern surgical techniques reduces pain in the postoperative period and the possibility of complications.
After the procedure, rest is required, plan to be absent from work or school for an average of 14 days. It is extremely important to follow the instructions of our staff to ensure a speedy recovery and reduce the possibility of complications.
At the Lohuis Filipović Polyclinic, we place great emphasis on an individual approach to patients. Our goal is to achieve a safe and long-term good result through a successful diagnosis and selection of individual treatment, with timely monitoring of the patient.
In our outpatient clinic for Otorhinolaryngology & Head and Neck Surgery, we have gathered an internationally recognized team of doctors closely specialized in solving individual problems that occur in the ear, nose and throat (ENT) and head and neck area, in adult patients and children.
Return to daily activities after removal of the third tonsil is expected approximately 2 weeks after the procedure. We recommend that you avoid sports activities and heavy lifting for about 3 weeks after the procedure.
During the postoperative period, avoid visits as they represent a potential source of infection.
After adenoidectomy, an open wound remains in the surgical area, i.e. there is no suturing, so it is necessary to follow the dietary instructions in detail. This will ensure proper wound healing and prevent the possible occurrence of complications, primarily bleeding.
A change in the voice after surgery is possible. Nasal speech usually occurs, which spontaneously stops as the surgical wound heals, in 2 to 3 weeks.
It is normal for pain to occur after the removal of the third tonsil, sore throat and fever, especially in the first few days.
For pain and fever, use analgesics and antipyretics as directed by your doctor. Proper hydration, consumption of more than 2 liters of fluid during the first three days after the procedure, is extremely important.
Immediately after the operation, you should only consume liquids, chilled tea, milk, apple juice and the like.
On the second day, you can introduce mushy foods such as pureed fruit, soup, vegetables.
From the third to the fifth day, you can consume overcooked rice and pasta, overcooked minced meat.
From the sixth day onwards, you can start eating normally, but it is necessary to avoid rough food that could cause damage to the operated area. For the same reason, excessively acidic, spicy, too cold or too hot foods should not be eaten.
The first three days you need to rest, and then you can start moving slowly. Negative pressure in the pharynx should not be exerted by coughing or strained speech.
After three days, you can start with a light activity, walk around the room every hour.
Going out and walks in the fresh air are recommended after the 8th postoperative day.
Complications after tonsillectomy, as a rule, occur rarely.
In the first week, the appearance of bleeding is possible . The symptoms you will notice are difficulty swallowing with the appearance of blood in saliva.
There may also be traces of blood in the vomited contents. If bleeding occurs, it is necessary to contact a doctor immediately.
During the first few hours after the procedure, nausea and vomiting may occur, mainly as a result of a reaction to anesthesia.
For this reason, we monitor patients in hospital conditions after surgery. If nausea and vomiting occur in the days after the procedure, be sure to contact a doctor.
In case you need surgery or just suspect that something is wrong, do not wait – make an appointment for your child today by calling +3851 2444 646, or by filling out the online form.
The main goal of LF Polyclinic is to improve the quality of life and health of our clients by providing them with top-notch healthcare services.
