When is Adenotonsillectomy Recommended?

• Recurrent tonsillitis (frequent, severe throat infections)
• Obstructive sleep-disordered breathing or obstructive sleep apnea (snoring, pauses in breathing)
• Chronic otitis media with effusion related to enlarged adenoids (glue ear)
• Difficulty swallowing, poor weight gain, or speech problems from large tonsils/adenoids
• Peritonsillar abscess not responding to drainage or recurrent abscesses

Techniques: Conventional, Endoscopic & Coblator

1. Conventional (Cold Steel / Electrocautery)

Traditional methods use scissors, dissectors, and sometimes electrocautery to remove tonsillar tissue. Reliable and widely used with predictable outcomes.

2. Endoscopic-Assisted Adenoidectomy

Endoscopic visualization improves precision when removing adenoids, reduces residual tissue, and lowers the risk of recurrence by ensuring complete clearance under direct vision.

3. Coblation (Low-Temperature Plasma)

Coblation uses radiofrequency energy in a saline medium to dissolve tissue at lower temperatures than electrocautery. It often results in less intraoperative bleeding, reduced postoperative pain, and faster recovery in selected patients.

4. Partial Tonsillectomy (Tonsillotomy)

In selected children with obstructive symptoms and infrequent infections, partial removal of tonsillar tissue can relieve obstruction while preserving some tonsillar tissue — may have quicker recovery but risk of regrowth.

Common Symptoms Leading to Surgery

• Frequent sore throats, fever, and tonsillar infections
• Loud snoring, mouth-breathing, daytime sleepiness, or poor school performance
• Nasal obstruction or chronic ear problems due to enlarged adenoids
• Peritonsillar swelling, difficulty opening mouth, or voice changes

Preoperative Evaluation

Appropriate assessment helps select the best procedure and reduces risks.

• Detailed clinical history and examination (frequency/severity of infections, sleep symptoms)
• Flexible nasal endoscopy or oral exam to assess tonsil/adenoid size
• Polysomnography (sleep study) in suspected obstructive sleep apnea or when indicated
• Routine blood tests, anaesthesia evaluation, and discussion of risks/benefits

How the Surgery Is Performed

Adenotonsillectomy is usually done under general anesthesia as a day-care or overnight procedure depending on age and comorbidities. Key steps include:

• General anaesthesia with airway protection
• Removal of tonsils using chosen technique (cold steel, electrocautery, or coblation)
• Adenoidectomy performed transorally; endoscopic assistance can be used for precise removal
• Hemostasis achieved; no external incision. Tonsil fossae may be left to heal by secondary intention or sutured as per surgeon preference

Recovery & Aftercare

Recovery timelines vary with age and technique — children generally recover faster than adults.

• Typical recovery: children 7–10 days, adults 10–14 days (may be longer with electrocautery)
• Pain is managed with prescribed analgesics and adequate fluids/soft diet
• Watch for fever, persistent bleeding, dehydration, or breathing issues and seek immediate care
• Follow-up visit to review healing and address any concerns

Risks & Possible Complications

• Pain and difficulty swallowing (expected)
• Postoperative bleeding (primary or secondary) — may require prompt attention
• Infection, rarely requiring antibiotics or drainage
• Changes in voice or taste (usually temporary)
• Very rare risks related to anaesthesia or surrounding structures

Benefits of Surgery

• Significant reduction in throat infections and antibiotic use
• Improved breathing, sleep quality, and daytime functioning
• Better ear function and fewer ear infections in adenoid-related cases
• Rapid symptom relief in most patients when correctly indicated

Why Choose Dr. Shrekha Padmakshan?

Dr. Shrekha Padmakshan offers experienced, evidence-based care in adenotonsillar surgery, selecting the best technique (conventional, endoscopic-assisted, or coblation) for each patient to optimise safety, comfort, and outcomes.

• Individualised surgical planning with modern techniques
• Multidisciplinary perioperative care and paediatric expertise
• Emphasis on pain minimisation, rapid recovery, and clear counselling
• Comprehensive follow-up to monitor healing and address any concerns

If recurrent throat infections, snoring, sleep problems, or ear issues are affecting you or your child, book a consultation to discuss whether Adenotonsillectomy (Conventional, Endoscopic, or Coblator) is the right option. We will evaluate, explain alternatives, and customise a safe plan for best long-term results.