Tonsillectomy is a surgical procedure involving the complete removal of the palatine tonsils, which are lymphoid tissues located on either side of the throat. Although tonsils play a role in immune defense during early childhood, recurrent or chronic infection can render them more harmful than beneficial. Tonsillectomy remains one of the most commonly performed ENT surgeries worldwide, particularly in children, but is also indicated in adolescents and adults under specific clinical circumstances.

The most common indication for tonsillectomy is recurrent tonsillitis. Patients who experience multiple documented episodes of acute tonsillitis each year, despite adequate medical treatment, are considered candidates for surgery. Chronic tonsillitis, characterized by persistent throat pain, halitosis, and enlarged tonsils, is another important indication. Tonsillectomy is also strongly recommended for obstructive symptoms, especially when enlarged tonsils contribute to snoring, sleep-disordered breathing, or obstructive sleep apnea. In such cases, the procedure significantly improves sleep quality, daytime alertness, and overall health.

Additional indications include peritonsillar abscess not responding to drainage, suspicion of malignancy, asymmetrical tonsillar enlargement, and complications such as difficulty swallowing or speech issues due to tonsillar hypertrophy. In children, recurrent infections can interfere with school attendance and development, making surgical intervention beneficial beyond symptom control.

The procedure is typically performed under general anesthesia. The surgeon accesses the tonsils through the mouth, eliminating the need for external incisions. Various surgical techniques may be used, including cold steel dissection, electrocautery, coblation, or harmonic scalpel methods. The choice of technique depends on patient factors, surgeon expertise, and institutional protocols. The primary goals are complete tonsil removal, effective bleeding control, and minimal tissue trauma.

Postoperative recovery usually takes 10 to 14 days. Pain is expected, particularly during swallowing, and may radiate to the ears due to shared nerve pathways. Adequate pain management, hydration, and soft diet are essential components of recovery. Temporary voice changes and bad breath may occur but resolve as healing progresses. Bleeding is a known but uncommon complication and requires immediate medical attention if it occurs.

Long-term outcomes following tonsillectomy are highly favorable. Patients experience significant reduction in throat infections, improved sleep quality, better breathing, and enhanced quality of life. ENT follow-up ensures proper healing and addresses any postoperative concerns.