Why You Shouldn’t Get a Tonsillectomy for Tonsil Stones


Tonsil stones are not a life-threatening condition and, in their moderate form, harbor minimal risk to your health. One may view a tonsillectomy as a minor operation, but like all surgery, tonsillectomies carry risks, including mortality. So, is a tonsillectomy a viable solution to your tonsil stone condition?

You shouldn’t get a tonsillectomy for tonsil stones because there are risks of postoperative complications such as hemorrhage, pneumonia, and infections. Also, the recovery time may be lengthy, painful, and you may even still get tonsil stones in the Lingual tonsils. However, if you have concurrent tonsillar conditions, surgery is an option.

Tonsil stones on their own are not a serious enough condition to necessitate surgery. However, if they occur alongside other potentially harmful conditions, surgery may be the best route. If you have a moderate case of tonsil stones, here are some reasons why a tonsillectomy might be a bad idea.

The Risks of Tonsil Surgery

Although tonsillectomies are a common surgery, figures often focus on pediatric surgery rather than the adult population. 

Clinically, children recover from tonsil surgery more quickly than adults, experience less pain and side effects. 

Although tonsillectomies are common, this does not change the fact that a tonsillectomy is a surgery and it carries with it all the corresponding risks of postoperative complications and potential mortality.

What Is a Tonsillectomy?

A tonsillectomy refers to a surgical procedure that removes all the palatine tonsil tissue from the oral cavity. Surgeons will either use a cold scalpel or ultrasonic/harmonic dissection to remove the tonsils. 

Harmonic dissection involves a scalpel vibrating ultrasonically at high intensity. The process generates heat to cauterize the cut as the surgery progresses. 

Often the term tonsillectomy is used interchangeably with a tonsillotomy, but the surgical procedures are different. 

  • Tonsillectomy proper or Extracapsular Tonsillectomy means removing the entire palatine tonsil area, including the tonsillar capsule. The tonsillar capsule refers to a thin fibrous area between the tonsil and the throat muscles.) The surgery leaves no lymphatic tissue on the arch of the palate.  
  • Tonsillotomy or partial/intracapsular tonsillectomy involves removing only part of the tonsil. Unlike the proper tonsillectomy, the procedure removes the tonsil tissue piece by piece leaving the capsule intact. 
  • Adenoidectomy involves the removal of the pharyngeal tonsils. Adenoidectomy may take place simultaneously as a tonsillectomy or may take the form of a separate surgery.

Let’s go over some of the risks of adult tonsillectomies below.

Going Under Anesthesia Is Never 100% Safe

Although some studies reflected that the adult tonsillectomy mortality rates were as high as one death in 20,000, recent studies suggest that the risk is far lower. 

A 2014 clinical study of 5968 patients estimated the mortality rate as low as 0.03% with only 1.2% surgical complications. 

Although professionals consider the adult tonsillectomy safe with relatively low morbidity and mortality, it is still a serious surgery. 

If your tonsil stones are not a severe condition and merely a discomfort, surgery is a high-risk procedure for a low-risk condition. 

There Could Be Postoperative Complications

Several postoperative complications may result after adult tonsillectomies. 

Researchers conducted a retrospective clinical study on 7,748 adult tonsillectomy patients with a mean age of 29.2 years. They found the figures as high as 11.65% had to consult medical help, of which 78.8% necessitates emergency treatment.

Of these revisits, the postoperative complications included:

  • 41.3% postoperative bleeding.
  • 22.1% acute pain.
  • 13.2% fever and dehydration.

Typically the complications of adult tonsil surgery cover common postoperative complaints, such as:

  • Postoperative bleeding may be primary (24hrs post-surgery) and secondary ( after 24 hours most often 5-10 days post-surgery. A clinical study of 112 patients showed that 3,5% suffered postoperative bleeding, of which 0.9% required surgery and 0,04% required blood transfusions. 
  • After a tonsillectomy, dehydration is a common side effect when pain causes patients to neglect to keep themselves hydrated. Dehydration has a further consequence of increasing the likelihood of postoperative bleeding. 
  • Infection is another primary postoperative complication after tonsil surgery. A study of 5968 adult tonsillectomy patients found that 58% of the patients suffered infections after surgery. 
  • Pneumonia is another common postoperative complication. In the same study as above, 27% of the 5968 case studies suffered pneumonia after their tonsil surgery. 

The Procedure Causes Pain and Has a Lengthy Recuperation

Patents often suffer from postoperative nausea and vomiting associated with reactions to anesthesia. There is also no doubt that an adult tonsillectomy is a painful process with a long healing time. 

In a study conducted on 77 adult tonsillectomy patients, researchers found most patients suffered 11-12 days of significant pain on average, but some experienced pain for up to 24 days.

Most patients take ten days to two weeks to return to normal functioning, but this may be longer if there are post-surgical complications. 

A study of over 70,000 patients reporting postoperative pain for various procedures. The patients consistently listed tonsillectomy as one of the top 25 painful surgeries on the extensive list. 

You Can Still Develop Tonsil Stones

While many people who suffer from tonsil stones report that their symptoms go away completely, there are still others who find that undergoing the painful surgery did not solve their problems.

When most people think about tonsil stones and where they come from, they are typically referring to the palatine tonsils on the sides of the throat. However, you actually have 3 different sets of tonsils:

  • Palatine. Sides of the throat.
  • Lingual. Deeper near the back of your tongue/throat.
  • Pharyngeal. Roof of your mouth behind the “punching bag”.

Your lingual tonsils, and sometimes even the Pharyngeal, are also a common location where you can develop tonsil stones, and removal of these may require an additional/separate tonsillectomy. Instead of undergoing invasive surgery that may not actually solve your issue, I recommend managing tonsil stones with my very quick morning routine.

When To Consider a Tonsillectomy

If you have a moderate case of tonsil stones with no other health complications, then you should seriously consider alternatives to tonsillectomy surgery. 

Although sometimes considered a ‘minor surgery,’ the effects of surgery carry the same weight as surgeries considered ‘major’ and all the associated mortality risks.

Typically the risks of tonsillectomy surgery are only viable when patients suffer the following conditions:

If You Have Recurrent Tonsillitis and Throat Infections

Recurrent tonsillitis and throat infections are primary indications for surgical intervention and tonsillectomy. Typically you would need to suffer:

  • at least seven episodes in a year, 
  • five episodes a year for two years
  • three documented episodes per year for three years.

If You Have Recurrent Peritonsillar Abscess 

Otherwise known as ‘quinsy,’ this condition is a secondary complication from recurrent strep throat or tonsillitis, where the infection of the tonsils spreads into the neck and chest. 

Pus collects between the palatine tonsils and the pharyngeal muscles, causing pain and infection. Swollen tissue may then lead to complications such as airway obstruction that requires a tonsillectomy. 

If You Suffer From Adult Obstructive Sleep Apnea

Tonsillar hypertrophy or growth can sometimes cause sleep apnea, where the air passage is blocked during sleep, preventing breathing episodically. 

A sign of sleep apnea is loud snoring, and the effects of obstructed airways during sleep may have a host of side effects in the sufferer’s life. 

The condition may cause fatigue, headaches and affect blood pressure. 

If You Experience Speech and Swallowing Difficulties

Tonsillar swelling and conditions may cause dysphagia or difficulty in swallowing, particularly in solid foods. 

Another side effect of enlarged tonsils is that the voice may become nasal and interfere with normal speech patterns. Doctors will often recommend a tonsillectomy if these conditions are present in a patient, 

Tonsillectomy Surgery Alternatives

Several methods of partial Tonsillectomy or tonsillotomy are available, which are typically less invasive and do not require that a patient undergo general anesthesia. 

These include:

Laser Tonsil Cryptolysis

Laser cryptolysis uses a carbon dioxide laser to smooth and flatten the tonsil surface. Tonsil stones form in the tonsillar crypts or crevices where debris such as food particles and saliva collect. 

The surgery requires no general anesthetic, so the secondary symptoms are less severe, and the surgery also minimizes bleeding and postoperative pain.  

Coblation Tonsil Cryptolysis

Coblation cryptolysis uses radiofrequency energy at lower temperatures than laser surgery with less damage to the surrounding tissue. 

Studies suggest that this surgical method is both safe and effective for tonsil stone and associated halitosis. It is also less invasive and has fewer post-surgical complications than traditional surgery. 

Conclusion

Although tonsillectomies are a standard procedure, they are not without their inherent risks, as well as a lengthy recovery time and postoperative pain. 

If your tonsil stones are not severe, and they are not impacting your life beyond being uncomfortable and unsightly, you should rather forgo the surgery option or choose a tonsillectomy. Otherwise, it is an extreme solution to a moderate condition. 

For more information on living your life free of tonsil stones, check out my blog where I cover tips, tools, and recipes.

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