In the past, tonsillectomy and adenoidectomy (T & A) was one of the most frequent surgical procedures performed on children, the most common indication being recurrent sore throat, though these procedures are performed much less often today. Currently, the most common indication for tonsillectomy in children is tonsillar hypertrophy with upper airway obstruction that results in snoring and sleep apnea. Other indications include recurrent tonsillitis and chronic tonsillitis. In adults, the most common indications are sleep apnea (as part of a uvulopalatopharyngoplasty), chronic tonsillitis, and concern for malignancy.

The adenoids are lymphoid tissue located in the nasopharynx. Adenoid hypertrophy results in nasal airway obstruction, mouth breathing, rhinorrhea, and sleep apnea. Due to the natural atrophy that occurs by puberty, adenoidectomy is usually only performed in children. It is frequently, but not always, done in conjunction with a tonsillectomy. The presence of significant adenoid tissue in an adult raises the concern for neoplasm or HIV infection.

T & A is performed under general anesthetic, usually in the outpatient setting. A careful preoperative history is necessary to rule out coagulation disorders. Bleeding is usually mild but can be considerable. Procedures are done using a combination of electrocautery and cold dissection; the use of electrocautery can reduce bleeding but may increase postoperative pain.

Usual postoperative course

Expected postoperative hospital stay

Patients are usually discharged on the day of surgery following a couple of hours of postoperative observation to assure that they can drink and hold down liquids.