To remove tonsils or not to remove?

My D is a freshman in college MT program and it seems she now requires tonsils be removed. She is a soprano and we are wondering how the surgery will affect her voice? How long true recovery is and what it takes to re-learn to sing without them. If we decide to do the surgery it will be over Christmas break. Thank you in advance for any input!!

I realize you are worried about her voice and want to hear others’ opinions, but I think this is entirely a medical situation, and as such, something better discussed with doctors as opposed to asking strangers on social media. Each person will be different; even if you find another singer here who got their tonsils removed over winter break, their particular situation and recovery will differ from your daughter’s.

If you’re concerned, I’d suggest a second opinion from another doctor, perhaps one specializing in voice.

Well, I’ll give you my 2 cents but it doesn’t relate to singing it relates to trumpet playing. My son was in a sleep study in high school and it was determined he really needed his humongous tonsils removed as he had sleep apnea due to the size of the tonsils. I didn’t think that was a good enough reason for surgery so he had a very expensive mouthpiece made which he wore approximately 1 week and never again even though he swore he’d wear it. The sleep apnea continued in college and when I took him to the oral surgeon to discuss removing the wisdom teeth he refused to do it until he had his tonsils removed unless he went into the hospital under full anesthesia instead of the Propothol stuff. We did see an ENT who took them out and said he would need to relearn to play the trumpet - highly exagerated, he had a larger cavity which made him have to learn new mouth/lip positioning but not relearn the trummpet. We did this the Monday after fall finals ended on Friday so that by the time Christmas day rolled around he could swallow meat…it worked out fine.

HUGE benefit - not even the slightest bit of a little snore…absolutely silent sleep. He is much more refreshed as well and the trumpet even better.

Hint - get a humdifier to pump moisture in the air so her throat doesn’t dry out…we got one of those airwashers that doesn’t actually spit water droplets in the air but evaporates it into the cool air. It help with the open mouth breathing during recovery.

My daughter had her tonsils removed the day before Christmas her freshman year of college after 3 bouts of strep her first semester. We are lucky that our insurance covered Dr. Jahn in NYC/NJ who is the ENT for the Metropolitan Opera; he took her voice and the surgery’s potential impact very seriously. She recovered in time to start rehearsals for 42nd Street 3.5 weeks later. She hasn’t had strep since, and she says she grew in range slightly. Feel free to PM me, @Joyfulmama .

1st, everyone we know who has had their tonsils out has had a different response/recovery from the surgery. Our D had to have hers removed after freshman year (adenoids were also removed) - after many years of problems - it was a last resort. She had them out in the summer, and ended up having to have vocal therapy - she had a “missing” place in her voice. It was strange and scary, but luckily we had an ENT and vocal therapist familiar with singers & it was fixed quickly and easily - it was a weird muscle issue & she just needed vocal exercises. She says she thinks she has a little more range - but that also might be because she has had such great vocal training at school & she doesn’t get strep throat multiple times a year anymore. She did put a note on her hospital gown before surgery saying “singer” so the anesthesiologist wouldn’t “forget” - she’d told him during our pre-surgery meeting! Happy to answer any questions.

Thank you all so much! @threeofthree yes that is helpful because I do hear some exaggerations on re-learning how to sing. So happy it worked out for your son!
@Calliene so great to hear, I am on Long Island and was trying to research voice doctors in the city so I will PM you to get more info!!! I read of one Dr. Milan R. Amin, MD @ NYU Voice Center Otolaryngology Associates. Did you research him?
@MTmom2017 that missing place is one of our concerns I am very happy to hear though that it was resolved.What a GREAT idea to write on her gown!!! Smart cookie!!!
Of course she is in Florida for school so makes seeing an ENT to schedule surgery more difficult! The ENT down there can refer but the ones up here still want to see her themselves of course.
I so appreciate all the comments!!

@Joyfulmama, no Dr. Amin never crossed our radar, I don’t think, but it was almost 3 years ago. I was strongly advised by some other parents to make sure to find an ENT who has worked with singers. Dr. Jahn was great so I would highly recommend him. He has also written a book:

https://www.amazon.com/Singers-Guide-Complete-Health/dp/0195374037/ref=sr_1_fkmr0_2?ie=UTF8&qid=1474414846&sr=8-2-fkmr0&keywords=Dr.+Jahn+voice

I don’t know if you were with MTCA but if so, Ellen also knew some people but I wasn’t able to connect with them.

I know everyone is different and we kind of took a leap since it was the only time she could do it. It worked out just fine in spite of our anxiety. But I don’t think my daughter has ever forgiven us for eating Chinese food on Xmas day when she couldn’t eat AT ALL. The first week or 2 are really tough. It was NOT a fun winter break.

If you are going to have it done, freshmen year is the time to do it. The older you are, the more painful the surgery is. Yes there will changes in the way she sings. The vocal tract is approximately 10cm long. Making any change, even 1-2 cm, changes the size of the vocal tract by 10-20%. However, as a freshmen she is going to have plenty of time to adapt and readjust her technique. In all cases I have ever seen, the voice opens up and singing becomes easier. It is absolutely imperative that you work with a skilled laryngologist at a voice center for the surgery. It is rare, but possible for the surgeon to damage the nerves that run through the muscles behind the tonsils which can cause permanent damage and affect the student’s ability to lift their palate. Again, that is rare. But a singer should not take a risk with a surgeon who does not fully understand the complex needs of professional singers. If it is medically necessary, then you do not have much of a choice. More than likely she will be very happy she had the surgery five years from now.

~VT

@Calliene I thought of contacting Ellen,so thank you for that reminder! Sounds like Dr. Jahn should be my first attempt though. I will call today and see how this will work with D being down in FL right now. Guessing a quick flight home for an appt will be necessary.
@VoiceTeacher I was hoping you would reply so thank you!!! It is very comforting and encouraging to hear that "In all cases I have ever seen, the voice opens up and singing becomes easier. " That is reassurance we/she needs to hear. Yes I am only looking at voice centers here in NYC, the only two I found were NYU Langone Dr. Amin or Dr. Jahn as @Calliene mentioned.

My daughter had no vocal changes after her surgery. Now she had it at 7 years old. It is harder to recover the older you are. But she had no issues with her voice due to the surgery. Good Luck!

@Joyfulmama both of the doctors you mention are excellent. I also like Dr. Peak Woo and Dr. Chandra Ivey.

~VT

Many many thanks @VoiceTeacher !!!

Great laryngologists in NYC who are experts on singers in general, including tonsil removal for singers, and also have expert voice therapists on their staffs include:

Dr. Milan Amin, NYU Voice Center
Dr. Mark Courey, Mt. Sinai Medical Center (head of UC San Francisco Voice Center for many years and recently relocated to NYC)
Dr. Michael Pitman, Columbia Presbyterian
Dr. Lucian Sulica, Weill Cornell/NY Presbyterian

Dr. Peak Woo and Dr. Chandra Ivey are also an expert NYC laryngologists in private practice together. They don’t have therapists on-site but can refer to one of the above Voice Centers for therapy.

I know the work of all of the above really well, having collaborated with all of those physicians as a voice therapist. I would (and do) endorse my students seeing any of the above, so see who takes your insurance! (I recently worked with my first Dr. Jahn patient and trust Calliene’s assessment of him.)

The biggest common concern after tonsil surgery in adulthood or teenage-hood is that the singer must NOT sing until there is no throat pain AT ALL. As the throat heals, the tissue contracts and you have to let that happen and then work gently through any feelings of tissue restriction AFTER pain is all gone, or you’ll likely introduce protective muscle tension into the pharynx (throat). This is why many singers do a short course of voice therapy after tonsillectomy.

@CoachC Thank so much for all the information! I am happy to see DR. Jahm and Dr. Amin’s names in your response Thank you also for explaining more about the post surgery regimen. .