Tonsil removal

my wife is 45 and still has her tonsils... what are the risks in her having them removed?

[Iceman465]

Oh yeah. she has also been fighting MRSA in her ears for that last *almost* 4 years. it keeps traveling from one ear to the other.

[Enoch Choi, MD]

Why is she having them removed?  That's not often necessary?

The risks of removal are bleeding, which can easily be stopped by cauterization.  Newer techniques are useful to minimize bleeding, pain, and make recovery more rapid.

stanford ENT dr. kay chang uses coblation for tonsillectomy and has much better results.  i would not use electrocautery, and instead choose coblation if it was my wife.

http://www.arthrocareent.com/wt/page/index

[Enoch Choi, MD]

MRSA is quite persistent.  Has she tried to eradicate by bactroban in the nostrils?  you too, and everyone in the household.

[OtoHNS_MD]

I agree that your wife should definitely meet the criteria for tonsillectomy before considering surgery.  Just because tonsils are present or enlarged, doesn't mean they need to come out.  

Risks include...bleeding (which can be severe and even life threatening) 3-4% chance, pain, injury to the mouth, lips, teeth, tongue, tongue weakness, taste decrease, voice change.  These are rare and overall this is a very straightforward surgery that takes about 15 minutes.

As far as technique,  there are pros and cons for each and you should ask the surgeon which technique they use and why.  Coblation tends to have less pain (although this is debateable for adults).  On the other hand, there are several published studies that show a higher bleeding rate with coblation, and some centers have abandoned that technique.  I know a lot of surgeons who use coblation and think it's great.  Just talk to your surgeon.  

[OtoHNS_MD]

I should add... whatever technique is used, as an adult this is a VERY VERY PAINFUL surgery.

[Enoch Choi, MD]

i agree with OtoHNS_MD's points.

[Iceman465]

thanks to borh of you for the input. as of now she is the only one that is getting mrsa in the house. other than twice when i got it in injured areas at work.

[Enoch Choi, MD]

if you got it from work, you need to try to eradicate it from yourself as well.  otherwise you'll pass it back and forth