Tonsillectomy

Tonsillectomy (TE) is a surgical procedure during which an otorhinolaryngologist removes the palatine tonsils (tonsillae palatinae).

Indication
TE should notbe indicated in children dbefore the age of 5 because of the immunological role of the tonsils.

Indications for tonsillectomy can be divided into local and general.

Local causes of TE indication

 * chronic tonsillitis;
 * recurrent angina;
 * hypertrophy of the tonsils resulting in dysphagia, dyspnoea or slurred speech;
 * specific inflammation (TB, syphilis);
 * tonsil tumor or suspicion of it;
 * SAS (sleep apnea syndrome);
 * parapharyngeal or paratonsillar abscess.

Common causes of TE indication

 * tonsillogenic sepsis;
 * metatonsillar complication (rheumatic fever).

Contraindications are agranulocytosis and blood diseases with coagulation disorders.

Execution
In children, TE is performed under general anesthesia, in adults it can also be performed under local anesthesia.
 * 1) We slowly dissect the tonsil and the capsule from the tonsillar bed.
 * 2) The tonsil can be removed using a tonsillar loop.
 * 3) Bleeding is stopped with a tourniquet.

After the procedure, we give the patient analgetics, apply cold compresses and, in indicated cases, administer antibiotics.

For non-infectious hypertrophy of the tonsils radiofrequency ablation or tonsillotomy (partial removal of the tonsils with a loop or laser – now no longer performed, because massive scarring and chronic inflammation in the rest of the tonsils ) is being discussed.

Complications
In theory, it is possible to injure the internal carotid artery and the ascending pharyngeal artery during TE, fortunately this does not happen in practice.

Related Articles

 * Chronic tonsillitis
 * Complications of tonsillitis
 * Angina