Tonsillectomy

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

Indication

TE should not be indicated in children before 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

Common causes of TE indication

Contraindications are agranulocytosis and blood diseases with coagulation disorders.[1]

Execution

A view of the oral cavity after a tonsillectomy

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 [1]) 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.

References

  1. ↑ a b HAHN, Aleš, et al. Otorinolaryngologie a foniatrie v současné praxi. 1. edition. 2007. 390 pp. ISBN 978-80-247-0529-3.

References

  • KLOZAR, Jan, et al. Speciální otorinolaryngologie. 1. edition. Galén, 2005. 224 pp. ISBN 80-7262-346-X.
  • VYHNÁNKOVÁ, Ludmila. Tonsillitis chronica a indikace k tonzilektomii. Pediatrie pro praxi [online]. 2008, y. 9, vol. 6, p. 361-363, Available from <http://www.solen.cz/pdfs/ped/2008/06/02.pdf>. ISSN 1803-5264.