Can Your Tonsils or Adenoids Grow Back After Surgery?

Amy felt great a few weeks after undergoing tonsillectomy for mild obstructive sleep apnea. She was sleeping better and was able to focus again in school. This lasted about 2 years, but her symptoms of fatigue, brain fog, and sleepiness slowly started to come back. It wasn’t to the same degree as before her surgery, but she felt a difference from just after surgery.
When I looked at her mouth, her tonsils did seem slightly enlarged. Before surgery, they were touching in the midline (called kissing tonsils). Now they were about 10-20% enlarged, especially in the highest part of the tonsil bed, near the soft palate. 
One of the most common questions I get from patients when I propose tonsillectomy is if tonsils can grow back after surgery. My general answer is that yes, in theory, but the overall chances are very small. It really depends on two main variables: how completely the tonsils were originally removed, and whether or not you have persistent inflammation that can cause additional swelling. 
In the old days, surgeons used to take out the entire tonsil, including the capsule that surrounds the tonsil on the sidewall of the throat. This was done for recurrent tonsillitis or for sleep apnea. With advances in technology, we can now shave down about 95% of the tonsils (sub-capsular or partial tonsillectomy), leaving a very thin cuff of tonsil tissue next to the capsule. This has been found to be relatively equivalent to total (extra capsular) tonsillectomy for obstructive sleep apnea, as well as being slightly less painful with with faster recovery. 
However, if you have persistent sources of inflammation, then any remaining tonsil tissues can slowly get bigger. This can aggravate more obstructed breathing, leading to more stomach juices being suctioned up into the throat, causing more tonsil swelling. Your tonsil tissues are made of lymphoid tissues, which helps educate your immune system and fight infections. In addition to your two tonsils, you also have adenoids (behind the nose) and lingual tonsils in the back of your tongue, just on top of your voicebox. Additionally, you have countless lymph nodes spread throughout your entire body.
Here’s what the research says:
Of 636 children (age < 11) who underwent partial tonsillectomy using Coblation technology, 33 patients (5%) had regrowth. Of these 33 patients, 5 needed repeat surgery due to recurrent symptoms. Of note, these 5 children’s age ranged from 1 to 3 years (1). Other studies found tonsil regrowth after partial tonsillectomy ranging from 6 to 17% (2,3). In most cases, patients did not feel any worsening of symptoms. As far as I can tell, there are no studies on rates of regrowth after total tonsillectomy. 
Adenoid tissues are more likely to come back, since it’s impossible to remove 100% of adenoid tissues (there’s no capsule). Investigators from Temple University found that 2 to 5 years after adenoidectomy, 46 out of 175 patients (26%) had symptoms of nasal congestion. Of the children who agreed to nasal endoscopy, not one patient had more than 40% regrowth, and about 70% had only trace or minimal degrees of regrowth (4). Another study from the Mayo clinic looked at 163 revision adenodectomies out of 8245 original cases. Initial younger age at surgery, presence of ear infections, and signs of acid reflux were significant risk factors for patients needing repeat adenoid surgery. Surgical technique, surgical experience, or the presence of allergies were not significant risk factors for needing repeat surgery (5). A third study found that about 13% of children had adenoid regrowth, but most were asymptomatic (6).
Lingual tonsils are not commonly taken out, and sometime can be a major source of obstructed breathing, Not surprisingly, the presence of acid reflux was strongly correlated to lingual tonsil size (7).
If you’re considering tonsil or adenoid surgery for yourself or your child, the good news is that for the vast majority of patients, tonsils and adenoids don’t grow back, but even if it does, it won’t cause any problems. Rarely do you have to go back to repeat the surgery.
What are your experiences with tonsil or adenoid regrowth? Did you have to go back to the operating room again?
1. Doshi, H. K., Rosow, D. E., Ward, R. F., & April, M. M. (2011). Age-related tonsillar regrowth in children undergoing powered intracapsular tonsillectomy. International journal of pediatric otorhinolaryngology75(11), 1395-1398.
2. Zhang, Q., Li, D., & Wang, H. (2014). Long term outcome of tonsillar regrowth after partial tonsillectomy in children with obstructive sleep apnea. Auris Nasus Larynx41(3), 299-302.
3. Çelenk, F., Bayazıt, Y. A., Yılmaz, M., Kemaloglu, Y. K., Uygur, K., Ceylan, A., & Korkuyu, E. (2008). Tonsillar regrowth following partial tonsillectomy with radiofrequency. International journal of pediatric otorhinolaryngology72(1), 19-22.
4. Buchinsky, F. J., Lowry, M. A., & Isaacson, G. (2000). Do adenoids regrow after excision?. Otolaryngology–Head and Neck Surgery123(5), 576-581.
5. Dearking, A. C., Lahr, B. D., Kuchena, A., & Orvidas, L. J. (2012). Factors associated with revision adenoidectomy. Otolaryngology–Head and Neck Surgery, 0194599811435971.
6. Kim, S. Y., Lee, W. H., Rhee, C. S., Lee, C. H., & Kim, J. W. (2013). Regrowth of the adenoids after coblation adenoidectomy: cephalometric analysis. The Laryngoscope123(10), 2567-2572.
7. DelGaudio, J. M., Iman, N., & Wise, J. C. (2008). Proximal pharyngeal reflux correlates with increasing severity of lingual tonsil hypertrophy. Otolaryngology–Head and Neck Surgery138(4), 473-478.

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12 thoughts on “Can Your Tonsils or Adenoids Grow Back After Surgery?

  1. Hey all so i had my tonsils removed in February and about 3 – 3 and a half weeks post op the pain was back and so was my left tonsil i was shocked and angry that it was so soon after the initial surgery! i had my second tonsillectomy on the left side last week and the pain is definitely worse. all i can say is i hope that was the last time! although it does make me wonder if there was another reason for it coming up so quickly? has anyone else experienced it coming back so soon ?

  2. My son was remove adonat and tonsels when he was 1year old he was fine for some months but now he has congested nose again and he snore too much while sleeping please assist

  3. Hi my daughter had her adenoids and tonsils removed with surgery,when she was almost two and then exactly two years later had the adenoids and grommets done… Its only been 1year and her adenoids r back,she can’t sleep well and I am worried. I asked the specialist at the hospital will it grow back and they said that once she turns 5 years it shouldn’t. She has recently been Ill with headaches and a temperatures for no reason, she will b fine and then tomorrow sick, and when she has a cold the ears start leaking. I am very worried… Will she get past this? Please help

  4. I had my adenoids taken out three times, just to grow back. The last Doctor ensured me that it would not grow back but it did about a month after the surgery. It like running on one cydiner every day for me. I’m fatigue all the time. How can i solve this problem?

  5. To everyone who had their adenoids grow back: Overall, it’s still very uncommon, but I do understand that of you, it’s a major problem. Adenoid regrowth can occur due to persistent allergies, acid reflux, for persistent sleep apnea.

  6. You say that the adenoids can cause sleep apnea. And that removal of the adenoids can alleviate sleep apnea. Then you say that sleep apnea can cause the adenoids to grow back! I’m confused.

    I’ve had my adenoids removed twice, and have just learned they are enlarged again and I’m going for a biopsy. I have snored since I was a young child, and I do have sleep apnea.

  7. Yes adenoids can grow back in my case they have grown back 3 times and I think it grew back a forth time

  8. 3 yrs ago at the age of 53 I developed strange growths in the back of my throat following a cold. I was sent to surgery for removal and biopsy. When I woke up I was told they were tonsil regroth from having them removed 48 yrs earlier. It was some of the worst pain I had ever experienced and it lasted for 10 days before I felt any relief. On top of that I began loud snoring and nasal drainage due to my adenoids also rejoining the party! I had been battling autoimmune disorders for the past 5 yrs including gastrointestinal challenges. Now I know there was a correlation. If only we could regrow something useful like a spinal cord or missing limb!

  9. I had my tonsils and adenoids removed at age 9 at age 37 just had them removed again. I was just diagnosed with an immune deficiency and I believe that is why the second surgery was necessary.

  10. Hello. My son is 5yo. Last year at 4, he had his tonsils and adenoids removed, but in just nine months, there was significant regrowth, such that all the signs had come back-fatigue, sleepiness during the day, snoring and apnea at night, ever having mucus and nose blockage and a chesty cough that is so hard to clear, occasional ear infections , we are always on medication and it’s wearing me out,, Especially the cold weather but also in dusty conditions. Should I consider second surgery for removal? Thank you.

  11. Had tonsils and adenoids removed at 2 years of age. In my forties now. I have reflux (never knew that was what I had as I had it my whole life) and it destroyed the enamel on the back of my teeth. As well i have had ringing in my ears for at least two decades and one side of my head will swell close if I lay on on my side. Plus one ear swells and feels clogged a lot. Anyway, No one has been able to figure it out as I’m otherwise healthy. So I take a lot of herbal allergy type remedies to reduce inflammation and it seems to help but it is a lot of work to remember to take (when I feel better I tend to stop and have to start again)
    Anyway, Your website made me feel better and at peace with what’s been going on my entire life.

  12. I had my tonsils and adenoids grow back 3 times from 2001 – 2014 time frame. So anything is possible no matter what research yall find.