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Various techniques may be used in a tonsillectomy. In some cases, all of the tissue that makes up the tonsils will be removed. In other cases, only part of the tonsil tissue is excised. The most common techniques used to perform a tonsillectomy include:

• Cold-knife dissection. This involves removal of the tonsils with a scalpel. It remains the most commonly used method of tonsillectomy. Post-operative bleeding typically is minimal.
  
  
• Electrocautery. Tonsillar tissue is burned away, while the remaining tissue is cauterized to reduce blood loss. The heat used in electrocautery reaches about 752 degrees Fahrenheit (400 degrees Celsius), and this may result in thermal (heat) injury to surrounding tissue, which may cause discomfort after the operation.
  
  
• Harmonic scalpel. Ultrasonic energy is used to vibrate the blade of this type of scalpel thousands of times per second. The vibration that is generated transfers energy to the tissue, causing simultaneous cutting and clotting of the tissue. Thermal injury to surrounding tissue is less likely than in electrocautery, because the harmonic scalpel raises temperatures in the tissue to 176 degrees Fahrenheit (80 degrees Celsius).
  
  
• Radiofrequency ablation. Probes are inserted into the tonsil and radiofrequency energy is transferred to the tonsil tissue. Scarring then occurs within the tonsil, causing it to shrink over a period of time. This procedure can be performed using light sedation or local anesthetia, and it produces minimal discomfort and requires minimal recovery time. However, tonsillar tissue remains after this procedure, so it typically is reserved for patients whose problems are associated with abnormally large tonsils that are not caused by tonsillitis. The procedure can be performed several times if necessary.
  
  
• Carbon dioxide laser (laser tonsil ablation). A laser vaporizes and removes tonsil tissue, which both reduces the volume of the tonsil and removes recesses in which chronic infections can collect. The procedure is performed in less than 30 minutes in an office setting, using local anesthetia. As with radiofrequency ablation, discomfort is minimal and recovery time is relatively short. It is often used to treat chronic recurrent tonsillitis, chronic sore throats, severe halitosis (bad breath) or airway obstruction due to excessively large tonsils. Post-procedure bleeding rarely occurs.
  
  
• Microdebrider. Uses a powered rotary shaving device to partially shave the tonsils. It is used when the tonsils are too big and cause an obstruction in the throat. After the procedure is finished, a natural biologic dressing is placed over the pharyngeal muscles to prevent inflammation and infection. The procedure results in reduced post-operative pain and a relatively rapid recovery.