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It is said we have three sets of tonsils;

  • Palatine tonsils   (as seen below - visualised in the oropharynx)

  • Lingual tonsils    (at the base of tongue) 

  • Adenoids            (in the nasopharynx) 

Collectively these tissues are known as Waldeyer's ring

Normal oropharynx
(large tonsils)
Post tonsillectomy appearance



Removal of the palatine tonsils. (seen in the oropharynx above)




Recurrent tonsillitis or quinsy, obstructive sleep apnoea, suspected malignancy.




Risks of hospital admission, anaesthesia, damage to teeth, jaw ache and click, neck ache, bleeding (7%) (may require blood transfusion (<0.5%)/return to theatre (2%)).



Lingual tonsillectomy


Removal of the lingual tonsils at the base of tongue (not seen in the diagram). It is possible to get lingual tonsillitis post palatine tonsillectomy and on rare occasions, a lingual tonsillectomy can be performed.




Removal of the adenoidal tissue from the nasopharynx.




Nasal obstruction and purulent discharge in children, bilateral persistent or recurrent otitis media with effusion, obstructive sleep apnoea (with tonsillectomy).




Risks of hospitalisation, anaesthesia, bleeding (<1%) (may require blood transfusion/ return to theatre)

There are specific criteria that a patient should fulfill to fit the criteria for a tonsillectomy. The original SIGN guidelines for these can be found in the following PDF.

Indication for tonsillectomy

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