Children usually undergo tonsillectomy, or removal of the tonsils. Only limited data are available regarding the indications for tonsillectomy in adults, as stated by Dr. E.K. Hoddeson in "Adult Tonsillectomy: Current Indications and Outcomes," published in the January 2009 issue of "Otolaryngology Head and Neck Surgery." Hoddeson conducted a review of medical records of 361 adult patients who underwent tonsillectomy from 2001 to 2007 and identified the indications.
Chronic Tonsillitis
Hoddeson states in his report that chronic infection, the most common reason for performing tonsillectomy in adults, occurred in 207, or 57 percent, of patients. These patients had a statistically significant increased incidence of postoperative bleeding.
Chronic tonsillitis causes bad breath from sulfur-producing bacteria embedded in the tonsillar crypts, swollen lymphatic neck nodes and sore throat. In a study published in the November 2001 issue of the "Archives of Otolaryngology Head and Neck Surgery," Dr. Neil Bhattacharyya reported that 65 adults surveyed noted significant improvement in their quality of life more than one year after surgery.
Upper Airway Obstruction
In Hoddeson's study, upper airway obstruction secondary to enlargement of the tonsils occurred in 98, or 27 percent of adult patients who underwent tonsillectomy. Upper airway obstruction strongly or absolutely indicates surgery. These patients had a statistically significant increased incidence of prolonged hospitalization or readmission.
Excessive swelling of the tonsils can result in respiratory distress in patients who have chronic obstructive pulmonary disease, or COPD. Tonsillar swelling may also cause snoring and disturbed sleep patterns, resulting in sleep disturbances or sleep apnea.
Suspected Cancer
Hoddeson states that suspected cancer resulted in tonsillectomy in the remaining 56, or 16 percent, of the adults in his study. Suspected cancer strongly indicates surgery.
The Merck Manuals Online Medical Library states that cancer of the tonsils occurs predominantly in men between the ages of 50 and 70. Smoking and alcohol consumption can cause cancer of the tonsils. According to ENT Center, cancers in the tonsils arise from the squamous epithelium and are called squamous cell cancer.
Virtual Medical Centre states that lymphoma causes tonsillar cancer and usually arises from the lymphatic cells, which are found in the wall of the tonsils.
If the tonsillar tumor is small, then a simple tonsillectomy and radiation therapy will suffice. About 50 percent of the people survive at least five years after diagnosis.
Stopping smoking and limiting alcohol consumption are ways to avoid tonsillar cancer.
References
- "Harrison's Principles of Internal Medicine"; Dennis Kasper, M.D.; 2005
- "Otolaryngology Head and Neck Surgery"; Adult Tonsillectomy: Current Indications and Outcomes; E.K. Hoddeson; January 2009
- Merck Manuals: Tonsillar Cancer
- Virtual Medical Centre: Tonsil Cancer
- ENT Center: Cancer of the Tonsil
