A, "Tonsillectomy," is a type of surgery to remove a person's tonsils. The glands are located at the back of the throat. Many times, a tonsillectomy is performed at the same time as an, "adnoidectomy," which is a surgery to remove a person's adenoid glands.
The tonsils and adenoids are part of the lymphatic system. Your tonsils are located in the back of the throat and adenoids are located higher up, behind the nose. The first treatment for infected tonsils and adenoids is a course of antibiotics. If you have frequent infections or difficulty breathing, you may need surgery. Surgery to remove the tonsils is called tonsillectomy. Surgery to remove adenoids is called adenoidectomy.
The person receiving the tonsillectomy is administered a general anesthesia prior to the surgery and is asleep; they do not feel any pain. A surgeon inserts a small tool into the person's mouth to prop it open. The surgeon the either cuts or burns away the person's tonsils. The surgeon controls the bleeding and the cuts heal naturally without stitches. The person is then taken to a recovery room until they are awake and can breath easily, cough, and have the ability to swallow. Most people are able to go home a few hours after a tonsillectomy.
A person's tonsils help to prevent against infections, but people with large tonsils might have several sore throats and ear infections. A doctor might consider a tonsillectomy if a person:
A tonsillectomy, like any type of surgery, presents risks. The risks associated with any surgery include bleeding and infection. The risks related to the use of anesthesia include breathing issues and reactions to medications. On rare occasion, bleeding after surgery may go unnoticed and cause bad issues. Swallowing a lot might be a sign of bleeding from a person's tonsils. Another risk involves injury to a person's, 'uvula,' or soft palate.
Before the tonsillectomy is performed, a person's doctor might as them to have blood testing such as a complete blood count, or tests to check their electrolytes or clotting factors. A doctor may also perform a physical examination and look at their medical history. It is always important to inform the doctor about the medications you are taking, to include any herbs, drugs, or vitamins you are taking that are not prescribed.
A person might be asked to stop taking things such as ibuprofen, aspirin, naproxen, warfarin, or other similar medications ten days before a tonsillectomy. It is important to ask the doctor which medications you should still take on the day of surgery. When the day of surgery arrives, take any medications your doctor has told you to with a small sip of water. You will usually be asked not to eat or drink anything for several hours prior to the tonsillectomy.
Tonsillectomies are often performed in either a hospital or a surgical center. People often go home the same day as the surgery. It is rare that a person has to stay overnight in the hospital for observation. Completely recovering from a tonsillectomy takes between one and two weeks. During the first week, a person should avoid others who are ill because it is easier to become infected during this period of time.
After a tonsillectomy, the number of throat infections a person experience is often lower, although they may still experience some. Unfortunately, there might be a time when antibiotics fail to resolve chronic tonsillar infections. People may also experience enlargement of their tonsils that causes loud snoring, upper airway obstruction, and other sleep disorders. The best solution for these conditions might be removal or reduction of their tonsils and adenoids.
The first reported tonsillectomy was performed by Roman surgeon Celsus in 30 A.D. Celsus described scraping the person's tonsils and tearing them out, or picking them up with a hook and excising them with a scalpel. Even today, a scalpel is the preferred surgical instrument of a number of ear, nose, and throat specialists. There are several other procedures that can be performed; however, and the choice might be dictated by the extent of the procedure to be performed such as a partial tonsillectomy versus a complete removal of a person's tonsils. Other considerations such as pain and post-operative bleeding are taking into consideration as well. What follows is a review of some of the procedures that are available.
Cold Knife Dissection:
Removal of a person's tonsils using a scalpel is the most common method practiced today. The procedure requires a person to undergo a type of general anesthesia. Their tonsils are then completely removed and they experience minimal post-operative bleeding.
Electrocautery burns a person's tonsillar tissue and helps to reduce blood loss through cauterization. Research has demonstrated that the heat of electrocautery results in thermal injury to the person's surrounding tissue and can result in more discomfort after the surgical procedure.
A harmonic scalpel is a medical device that uses ultrasonic energy to vibrate a blade at 55,000 cycles each second. While this is invisible to the eye, the vibration transfers energy to the tissue and provides simultaneous cutting and coagulation. The temperature of the surrounding tissue reaches eighty degrees Celsius. Use of a harmonic scalpel results in precision cutting with a minimum of thermal damage.
Bipolar Radiofrequency Ablation:
A bipolar radiofrequency ablation produces an ionized saline capable of disrupting molecular bonds without the use of heat. As energy is transferred to the person's tissue, ionic dissociation happens; a mechanism that may be used to remove all or only a portion of the person's tonsils. The procedure is performed under a general anesthesia in an operating room and may be used for chronic or recurrent infection or enlargement of the tonsils. The advantages of this particular technique include less pain, faster healing and less need for care after surgery.
A microdebrider is a powered rotary shaving device with continuous suction that is many times used during sinus surgery. The tool is made up of a tube that is connected to a hand piece that is connected to a motor with a foot control and a suction device. A microdebrider is used to perform a partial tonsillectomy by shaving a person's tonsils. The procedure eliminates the portion of the person's tonsils that are causing an obstruction while preserving their tonsillar capsule. A natural biologic dressing is placed of the person's pharyngeal muscles to prevent injury, infection, and inflammation. The procedure results in less pain and a quicker recovery. The procedure is recommended for people with enlarged tonsils, not those who experience repeated infections.
Monopolar radiofrequency thermal ablation transfers radiofrequency energy to a person's tonsil tissue through probes that are inserted in their tonsil. The procedure may be performed in an office setting under a local anesthesia or light sedation. After the treatment has been performed scarring occurs within the tonsil and causes it to decrease in size over a period of a number of weeks. The treatment may be performed several times.
The advantage of the technique is that it presents a minimum of discomfort, the procedure is fairly easy, and people can immediately return to work or school. The person's tonsillar tissue remains after the procedure has been performed, although it is less prominent. Radiofrequency ablation is a procedure that is recommended for treatment of enlarged tonsils and not recurrent or chronic tonsillitis.
Carbon Dioxide Laser:
'Laser Tonsil Ablation (LTA),' involves an otolaryngologist using a hand-held CO2 or KTP laser to vaporize and remove a person's tonsil tissue. The technique reduces the person's tonsil volume and eliminates recesses in their tonsils that collect recurrent and chronic infections. The procedure is recommended for chronic sore throats, recurrent tonsillitis, airway obstruction caused by enlarged tonsils, and severe halitosis. An LTA is performed in around fifteen to twenty minutes in an office setting and requires only a local anesthetic. The person leaves the office with a minimum of discomfort and is able to return to work or school the next day. Bleeding after the procedure might happen in around one-to-five percent of people. Research studies have stated that laser technology provides significantly less pain during the post-operative recovery of the person, results in less sleep disturbance, and less need for medications.