Tonsillectomy is one of the most common surgeries performed on children, but sometimes adults need to have their tonsils removed, too. Infection is the most likely reason your doctor may recommend a tonsillectomy. Another reason is having tonsils that are so large they obstruct your airway and cause sleep apnea -- brief periods during which you stop breathing in your sleep.
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More than 10 percent of office visits to primary care providers are for sore throat, which may be due to inflamed tonsils or simply inflammation of the back of your throat. It is common to also experience sore glands in the front of your neck, as well as fever. You might even notice a white coating on your tonsils, especially if you have a bacterial infection, such as strep throat. The most likely reasons your doctor may refer you for tonsillectomy are very frequent sore throats or a chronic infection in your tonsils. If you have infrequent, uncomplicated infections, your doctor will probably just treat you with reassurance and antibiotics, if needed.
Abscess On Your Tonsils
If you experience severe pain, fever, significant bulging around your tonsil, pain when you open your mouth or you notice your uvula is shifted to one side, you may have a peritonsillar abscess and should seek medical attention immediately. A peritonsillar abscess is a collection of pus near the tonsils due to infection by one or many bacterium. While it is typically treated with antibiotics and drainage, 10 to 15 percent of the time the abscess returns, prompting some clinicians to recommend tonsillectomy early in the course of treatment rather than waiting for a potential recurrence.
If your tonsils are enlarged, they may actually obstruct your airway when you lie down and cause you to completely stop breathing in your sleep, a condition called sleep apnea. You may wake up in the middle of the night gasping for breath. Chances are, if you have sleep apnea, you may have been told that you snore loudly as well, though loud snoring does not necessarily mean you have sleep apnea. Not all sleep apnea is caused by enlarged tonsils, but if your doctor suspects this is the problem, she may recommend tonsillectomy.
One Big Tonsil
If one of your tonsils is much larger than the other, your doctor may recommend tonsillectomy as a precaution to rule out a serious underlying cause. Surgery is typically recommended only if you have other related symptoms. If you don't have other "red flag" problems, such as difficulty swallowing, persistent pain, swelling of the glands in your neck, or one tonsil that keeps getting larger and larger over time, it is extremely unlikely that the difference in size of your tonsils is important. Most of the time, having one enlarged tonsil is simply due to a minor issue, such as one tonsil scarring more than other from past infections.