How is tonsil removal done?

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Method of removing tonsils in adults

Removal of tonsils (tonsillectomy) is used in otolaryngology to eliminate chronic foci of inflammation in the oropharynx and prevent post-infectious complications. Surgery involves excision of lymphadenoid formations along with the connective tissue (tonsilica) capsule.

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Timely surgical treatment makes it possible to stop catarrhal processes in the pharyngeal mucosa, which prevents the occurrence of peritonsillar abscess and systemic diseases. Tonsillectomy is resorted to only in cases where drug treatment of infectious pathologies does not produce the necessary results. Direct indications for cutting out the palatine tonsils (tonsils) are hypertrophic and chronic tonsillitis, myocarditis and pyelonephritis, meningitis and rheumatism, etc. Delayed elimination of foci of inflammation provokes intoxication of the body, which creates additional stress on the heart, kidneys and joints.

Types of tonsillectomy

How tonsils are cut out - how is tonsil removal done in adults? Modern surgery has a considerable range of tonsillectomy methods, which have fundamental differences among themselves. The choice of the appropriate method for removing lymphoid formations is determined by a specialist and largely depends on the extent of inflammation, the presence of complications, the age and medical history of the patient.

The most common methods for removing tonsils include:

  1. extracapsular tonsillectomy - mechanical excision of the tonsils using a scalpel and a metal loop; used to open purulent abscesses and infiltrates;
  2. cryodestruction - cauterization of the tonsils with liquid nitrogen, which provokes necrotization of lymphoid tissues affected by inflammation;
  3. electrocoagulation – cutting out the tonsils with high-frequency electric currents; anemic surgery often leads to the formation of thermal burns and, accordingly, tissue necrosis;
  4. ultrasonic ectomy – separation of lymphoid tissues from the mucous membrane of the oropharynx using high-frequency sound vibrations;
  5. radiofrequency ablation – partial removal of the tonsils with a radio wave “knife” with minimal postoperative consequences; used, as a rule, to reduce the size of hypertrophied tonsils;
  6. thermal welding - excision of areas of the tonsils affected by inflammation with an infrared laser under local anesthesia;
  7. vaporization – destruction of soft tissues with a carbon laser with minimal heating of adjacent tissues;
  8. removal with a microdebrider - removal of soft tissues with a device with a rotating blade (microdebrider);
  9. bipolar coblation - removal of the tonsils using radiofrequency energy converted into ionic dissociation.

Mechanical excision of the palatine tonsils is used, as a rule, in the presence of diffuse inflammation in the mucous membrane of the oropharynx and the occurrence of a retropharyngeal abscess. The operation is performed under general anesthesia and is characterized by the removal of not only paired organs, but also the peri-almond tissue. After the procedure, patients often complain of severe sore throat, tissue swelling and a long rehabilitation period.

In the absence of serious complications or partial damage to the tonsils, a tonsillotomy is performed, i.e. partial removal of tonsils.

Surgical treatment is carried out using vaporization, radiofrequency ablation, cryodestruction or thermal welding. Before the procedure, the area of ​​tissue to be removed is treated with a local anesthetic, which prevents the occurrence of pain and severe swelling in the operated tonsil.

Preparing for surgery

Preparation for surgery occurs on an outpatient basis approximately 2-3 weeks before the decision to undergo tonsillectomy is made. How are tonsils removed? The method of excision of the tonsils is determined only after studying the results of the analysis and the patient’s medical history. Not all patients tolerate general anesthesia equally well, which should be taken into account.

To prevent complications, the patient must undergo the following tests before surgery:

  • coagulogram – allows you to determine the rate of blood clotting;
  • general blood test - shows the concentration of neutrophils and red blood cells in the blood, thanks to which you can find out the prevalence of infectious processes in the body;
  • general urinalysis - gives information about the physical and chemical characteristics of urine, the functioning of detoxification organs, the concentration of proteins and hemoglobin.

After studying the tests, the specialist can determine the likelihood of delayed bleeding, hematomas and other complications. If necessary, the patient is prescribed coagulants and hemostatic agents in advance, which promote thrombosis of large and small vessels in the operated tissues.

Important! An overdose of coagulants can cause anaphylactic shock.

Features of tonsillectomy

How are tonsils removed? Depending on the chosen method of excision of the tonsils, the operation is performed under local or general anesthesia.

In the absence of serious contraindications, anesthesiologists administer general anesthesia, which prevents stress in the patient during surgical procedures.

  1. An anesthesiologist administers general anesthesia or numbs the throat with local drugs;
  2. Using a scalpel, microdebrider, laser or ultrasound device, the surgeon excises the tonsils;
  3. if necessary, damaged vessels are cauterized with electric current (electrocoagulation) to prevent blood loss;
  4. The operated patient is placed on his side with an ice bag placed on his neck.

Mucus and blood are spit out for 3-4 hours after surgery to prevent aspiration and pulmonary complications.

Failure to comply with the rules of the rehabilitation program can lead to the development of severe complications, in particular septic inflammation of the operated tissues. To prevent the development of infection, the patient should take broad-spectrum antibiotics for 1-2 weeks.

Contraindications

Surgery is more difficult for adults than for preschool children. This is largely due to the presence of chronic diseases and a slowdown in metabolic processes, which negatively affects the speed of regeneration processes. Direct contraindications for surgical treatment are:

  • oncological diseases;
  • active tuberculosis;
  • pulmonary pathologies;
  • blood diseases (leukemia, hemophilia);
  • diabetes;
  • exacerbation of chronic diseases;
  • bone marrow pathologies;
  • cardiovascular diseases;
  • gestation period;
  • respiratory diseases.

Removing the tonsils leads to a decrease in the body's reactivity, which increases the risk of developing infectious diseases such as pneumonia, bronchitis, pharyngitis, etc.

Partial resection of lymphoid tissue helps preserve the functions of the palatine tonsils, which take part in the synthesis of immunoglobulin. That is why otolaryngologists recommend not delaying a visit to a specialist if chronic inflammation develops, which can result in the generalization of pathological processes.

Author: Guseinova Irada

Comments and reviews

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    Should tonsils be removed for chronic tonsillitis? Methods for removing tonsils

    Frequent sore throats against the background of reduced immunity often lead to the formation of chronic tonsillitis. Many people associate this diagnosis with tonsil removal. However, any qualified doctor will confirm that there are no extra organs in the body, be it tonsils or appendicitis. Therefore, surgical intervention should be approached carefully, weighing all the pros and cons.

    Why are tonsils needed?

    The tonsils are lymphoid tissue located between the palatine arches. The tonsils are part of a kind of lymphoid ring in the throat. It is this that delays the infection entering the body with air and food. When the immune system is weakened, the tonsils cease to be “defenders”; in the event of a serious attack of infection, the tonsils become inflamed and the doctor diagnoses “acute tonsillitis”.

    Everything is not so scary if a sore throat is an isolated case and is treated in a timely manner. Frequent inflammation of the throat can form chronic tonsillitis, while lymphoid cells proliferate and the tonsils increase in size. Then the tonsils cease to protect against bacteria and viruses, turning into a chronic breeding ground for infection.

    Chronic tonsillitis, as a rule, develops in children; children often suffer from colds. However, adults are not protected from this disease; untimely or improper treatment of tonsillitis can lead to the formation of complications against the background of already acquired diseases.

    An increase in the size of the tonsils can cause difficulty breathing; in adults, chronic tonsillitis is often accompanied by snoring. As with any chronic inflammatory disease, a stable increase in temperature can be observed. In this case, patients complain of general malaise, pain when eating, and difficulty swallowing.

    When is it necessary to remove tonsils?

    Previously, removal of the tonsils was performed in almost every patient with chronic tonsillitis, especially if the proliferation (hypertrophy) of the tonsils was grade II-III.

    It is believed that the tonsils function only up to 5 years of age; after that, the tonsils are practically useless. An operation to remove the tonsils 10 years ago was prescribed from the age of 3; now the removal is performed on adults and children over 5 years of age.

    However, modern doctors are not so categorical regarding this diagnosis and, if possible, use conservative treatment methods. Now pharmaceuticals offer a wide range of medications that can significantly reduce the size of the tonsils, and in combination with physiotherapy, minimize the risk of chronic tonsillitis.

    It is necessary to remove tonsils if:

    • a person suffers from tonsillitis more than 4 times a year;
    • against the background of chronic tonsillitis, pathological processes occur (rheumatism, kidney damage, liver damage);
    • tonsillitis is complicated by the development of abscesses, the inflammatory process extends beyond the tonsils;
    • there is no effect in the treatment of chronic tonsillitis using conservative methods.

    Attention: Whether to remove tonsils is decided solely by an ENT doctor, based on the external picture of inflammation in the throat, the state of the body’s immune forces and the advisability of conservative treatment.

    Removal of the tonsils can be partial (tonsillotomy) or complete (tonsillectomy). In addition to conventional surgery, hardware techniques are used, the main advantage of which is less trauma, and therefore a shorter recovery period.

    Methods of tonsillotomy

    Many adults have witnessed the surgical removal of tonsils in their children: the child’s fear of the operation, crying and screaming, hoarse voice. How do modern doctors remove tonsils? Modern technologies make it possible to perform surgery to remove tonsils as painlessly and less traumatically for the patient’s psyche.

    The tonsils are partially removed to preserve their basic function and facilitate breathing in cases of severe hypertrophy and in the presence of contraindications to the complete removal of the tonsils. Tonsillotomy is performed in the following ways:

    • cryosurgery (freezing with liquid nitrogen);
    • using an infrared or more modern carbon laser (cauterizing effect).

    The surface of the tonsil treated under local anesthesia dies and is subsequently removed. These techniques are virtually painless and the likelihood of bleeding is very low. However, after the operation, short-term sore throat is possible due to partial removal of tonsil tissue. Sometimes the temperature rises after surgery.

    Attention: When performing tonsillotomy, the ability of lymphoid tissue to grow should be taken into account. Some time after the operation, the tonsils may increase again to a large size. In order to prevent subsequent enlargement of the tonsils, regular courses of conservative therapy are necessary.

    Methods of tonsillectomy

    In case of complicated tonsillitis or an advanced chronic process, they resort to complete removal of the tonsils. During tonsillectomy, all lymphoid tissue of the tonsil is removed along with the connective tissue capsule. If it is necessary to completely remove the tonsils, the doctor decides which of the following methods is most appropriate in this case.

    Surgical intervention

    As before, surgical removal is performed with a wire loop and surgical scissors. However, modern surgeons perform tonsillectomy under general anesthesia; previously only local anesthesia was used. The disadvantages of surgical removal of tonsils are:

    • long recovery period (up to 2 weeks);
    • bleeding may be quite extensive;
    • The use of general anesthesia is not always justified.

    Surgery to remove the tonsils, often practiced in Soviet times, is fraught with very serious complications. Just 2 mm from the tonsils there are large blood vessels, accidental damage to which can cause severe bleeding and be life-threatening. In this case, the lymphoid tissue must be completely removed; even a small remnant of it leads to further growth, which reduces the effectiveness of the operation to nothing. Therefore, the surgeon performing such operations must have sufficient experience to remove the tonsils with “jewelry” precision.

    Laser destruction

    As in the case of partial removal, tonsillectomy is performed using an infrared or carbon laser machine. This is the most gentle way to get rid of tonsils. Operation:

    • performed on an outpatient basis;
    • painless;
    • practically bloodless;
    • minimum time spent under medical supervision (from 2 hours to 1 day);
    • rapid wound healing.

    Electrocoagulation

    Hypertrophied tonsils are cauterized with high-frequency electric current. As scary as it may sound, the method is practically painless and the likelihood of bleeding is minimal. Sometimes a burn occurs to the healthy tissue surrounding the tonsil, which causes discomfort after surgery.

    Contraindications to tonsillectomy:

    • low level of blood clotting (diabetes mellitus);
    • acute stage of infectious diseases;
    • cardiovascular diseases (angina pectoris, severe hypertension, tachycardia);
    • tuberculosis;
    • 6-9 months of pregnancy.

    Removal of tonsils: pros and cons

    Surgeries on the tonsils have their positive and negative sides, which is why the attending physician’s decision to get rid of the tonsils must be balanced and calculated.

    The positive effect of the operation is beyond doubt:

    • the risk of complications (renal, cardiovascular, etc.) disappears;
    • the person is not bothered by sore throats;
    • the source of infection disappears;
    • the swallowing process is restored;
    • general strengthening of the body.

    However, there are also negative consequences of tonsil removal:

    • possible bleeding during surgery;
    • re-proliferation of lymphoid tissue due to incomplete removal;
    • pharyngitis and bronchitis take the place of sore throats (since the palatine tonsils took on the role of the main “defender” against viruses and bacteria, their absence can lead to infection penetrating deeper into the respiratory tract).

    There is an opinion that removal of tonsils negatively affects girls during puberty. Removed tonsils supposedly affect fertility. Such statements are just fiction. The stress that accompanies the operation may have a negative effect, but not the fact of the operation itself.

    Important: A patient who is scheduled for surgery to remove tonsils should be familiar with the method of performing it and the possible consequences.

    Whether or not to have your tonsils removed is a big decision. It is worth noting: radical and conservative methods of getting rid of tonsils should be accompanied by measures to strengthen the immune system. A list of simple rules that will protect against acute diseases of the tonsils, chronic inflammation and subsequent surgery to remove them:

    • hardening;
    • physical activity;
    • good nutrition (replenishing the lack of vitamins and microelements with complex vitamin preparations);
    • quitting smoking and drinking alcohol.

    Treatment of chronic tonsillitis should not end with removal. Only an integrated approach including drugs that stimulate the defenses, physiotherapy and hardening measures will provide lasting immunity and protect against any infections.

    Source: http://anginet.ru/tonzillit/udalyat-li-mindaliny-pri-tonzillite

    Consequences of surgery to remove tonsils

    Removing the tonsils (tonsillectomy) is a fairly simple surgical procedure, but, like any operation, it can have dire consequences.

    There may be several reasons: from the initial state of health of the patient to the incorrect actions of the operating doctor. Of course, it is preferable not to bring the tonsils to the point where they need to be removed, but if the procedure is unavoidable, you need to be aware of the possible consequences.

    Functions of the tonsils

    Tonsils are a very important part of the human immune system. Microbes and bacteria entering the body through airborne droplets first encounter resistance in the nasopharynx. The tonsils are located between the oral cavity and pharynx and are protected by the mucous membrane.

    The functions of these organs come down to two main ones: hematopoiesis and the development of immunity.

    Not so long ago, tonsillectomy (removal of the tonsils) was considered a routine operation, as it was performed to prevent inflammation of the kidneys and heart in children. But saving the body from more serious diseases led to the deprivation of an important part of its protection.

    The tonsils are part of the immune and lymphatic system. Read more here.

    There are indications in which surgical intervention is inevitable:

    • chronic tonsillitis, resulting from frequent relapses of tonsillitis;
    • purulent tissue inflammation (abscesses) that spread to the larynx;
    • blocking of the respiratory tract by the tonsils;
    • sudden severe decline in immunity;
    • frequent occurrence of sore throat (more than 3 times a year).

    However, each case requires an individual approach. Not all large tonsils need to be removed, but small ones can hide a huge health threat.

    Consequences

    The consequences of tonsil removal are the same for children and adult men and women.

    When agreeing to surgery, you should know what you are losing:

  • Tonsils serve as a shield against infections. After their elimination, viruses can operate with impunity not only in the pharynx, but also spread to the larynx, trachea, bronchi and even lungs, and provoke many other diseases that can become chronic: laryngitis, bronchitis, even pneumonia.
  • The immune system is deprived of an important organ that produces macrophages that eat bacterial cells and viruses. Thus, local immunity suffers.
  • Lymphocytes begin to be produced in smaller numbers, and, as a result, antibodies. Humoral immunity becomes weaker.
  • Antiallergic protection is noticeably reduced. For example, in people predisposed to allergies, bronchial asthma may begin, and in people with allergies, attacks become aggravated and become more frequent.

    • Refusal of tonsillectomy will entail the following consequences:

  • If they do not work properly and do not perform their natural functions, the tonsils begin to accumulate infections. They turn into a breeding ground for germs and also become a source of unpleasant odors.
  • Recurrences of sore throat will never stop, and every year they will become more frequent, and the consequences will become worse.
  • With an increased size of the tonsils, it becomes difficult to breathe, and snoring appears at night. A person suffers from a lack of oxygen.
    • Contraindications for this operation:
    • poor blood clotting;
    • serious problems with the heart, kidneys;
    • severe form of hypertension;
    • diabetes mellitus, tuberculosis;
    • various acute forms of infectious diseases;
    • third trimester of pregnancy.

    Watch a video about the consequences of tonsillectomy:

    Possible complications

    After removal of the tonsils, the following complications are possible:

  • Severe sore throat. This is not always a bad thing, it’s just the body’s reaction to injury, and over time the discomfort will go away. But if the torment does not go away for several weeks, you should consult a doctor.
  • When consuming cold food and drinks, the mucous membrane of the throat becomes inflamed faster.
  • In rare cases, bleeding may occur.
  • If the tonsils were infected at the time of removal, then there is a risk of the infection spreading further through the lymphatic and blood vessels.
  • An allergic reaction to a pain reliever.
  • If laser removal of tonsils is performed incorrectly, there may be a burn to the mucous membrane and soft tissues.

    • The body's response to tonsillectomy in children and adults is somewhat different. Children often have a fever, nausea (less often vomiting) after the procedure, sometimes the timbre of their voice changes, and not only their throat hurts, but also their lower jaw and neck.

    Typically, a child’s body tolerates such stress more easily and copes within a week. Adults may experience an unpleasant taste in the mouth, a rise in temperature, and rarely bleeding. The recovery period lasts longer and is more painful.

    To avoid having to undergo surgery, try lymphatic drainage massage as a preventative measure.

    So, if your tonsils have completely stopped coping with their task and are only causing harm to the body, then you should not be afraid of going to the doctor because of a possible surgery.

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    Source: http://limfamed.ru/stroenie/mindaliny/posledstviya-udaleniya-gland.html

    Tonsil removal in adults

    Having suffered from chronic tonsillitis, some patients decide to have their tonsils removed. In what cases is surgery indicated, how is it performed and what consequences can be expected from it?

    When should you have your tonsils removed?

    Removal of the palatine tonsils (tonsillectomy) is resorted to only when it is no longer possible to restore the function of the immune organ. The main indications for the operation are:

    • Frequent exacerbations of chronic streptococcal tonsillitis. The fact that the causative agent of the patient’s disease is streptococcus should be confirmed by a blood test for the titer of antistreptolysin O. Its increase reliably indicates the body’s reaction to streptococcus. If taking antibiotics does not lead to a decrease in titer, then it is better to remove the tonsils, otherwise there is a high risk of complications.
    • Increase in the size of the tonsils. Overgrowth of lymphoid tissue can cause discomfort when swallowing or sleep apnea (breathing while sleeping).
    • Damage to the tissues of the heart, joints and kidneys due to intoxication of the body. To establish a connection between inflammation of the tonsils and organ dysfunction, the patient is asked to perform so-called rheumatoid tests - tests for C-reactive protein, sialic acids and rheumatoid factor.
    • Peritonsillar abscess. This is a condition in which inflammation spreads from the tonsils to the surrounding soft tissue. Usually, the pathology is “silenced” with medications and only then the operation begins.
    • Ineffectiveness of conservative methods of therapy (including taking medications, rinsing, vacuum removal of tonsil plugs and physiotherapy).

    How to prepare for a tonsillectomy

    Preparation for tonsillectomy is carried out on an outpatient basis. The patient needs to undergo a number of tests:

    • general blood analysis,
    • analysis to determine the number of platelets,
    • coagulogram (blood test for clotting),
    • general urine analysis.

    You will need to be examined by a dentist, cardiologist and therapist. If a pathology is identified, consultation with an appropriate specialist is indicated.

    To reduce the risk of bleeding, 2 weeks before surgery the patient is prescribed medications that increase blood clotting. They ask you to stop taking aspirin and ibuprofen for 3-4 weeks.

    Day of surgery

    The doctor decides how exactly the operation will take place. Typically, the entire tonsils are removed. Partial tonsillectomy can be performed in cases of severe hypertrophy of lymphoid tissue.

    6 hours before the procedure, the patient is asked to stop eating, drinking dairy products and juices. You can’t even drink water for 4 hours.

    Tonsil removal in adults is usually performed under local anesthesia. Half an hour before surgery, the patient is given an intramuscular injection with a sedative, then an anesthetic, lidocaine, is injected into the tissue around the tonsil.

    In the operating room, the patient is seated in a chair. Inflamed organs are removed through the mouth. No incisions are made on the neck or chin.

    Tonsillectomy options:

    • Traditional operation. Tonsils are removed using traditional surgical instruments - scissors, scalpel and snare.

    Pros: the method is time-tested and well proven.

    Cons: long rehabilitation period.

    • Infrared laser surgery. Lymphoid tissue is excised with a laser.

    Pros: almost complete absence of swelling and pain after the procedure, ease of implementation, the operation can be performed even on an outpatient basis.

    Cons: there is a risk of burns to healthy tissue surrounding the tonsil.

    • Using an ultrasonic scalpel. Ultrasound heats the tissue to 80 degrees and cuts off the tonsils along with the capsule.

    Pros: minimal damage to adjacent tissues, rapid healing.

    Cons: there is a risk of bleeding after surgery.

    • Bipolar radiofrequency ablation (collaboration). The tonsils are cut off with a cold radio knife, without heating the tissue. The technology allows you to remove the entire tonsil or just part of it.

    Pros: no pain after surgery, short recovery period, low complication rate.

    Cons: performed only under general anesthesia.

    The entire operation takes no more than 30 minutes. After its completion, the patient is taken to the ward, where he is placed on his right side. An ice pack is applied to the neck. You are asked to spit saliva into a special container or onto a diaper. During the day (and during collocation - no more than 5 hours), the patient is not allowed to eat, drink or gargle. If you are very thirsty, you can take a few sips of cool water.

    Frequent complaints after surgery are sore throat, nausea, dizziness. Sometimes bleeding may occur.

    Depending on the method of tonsillectomy, the patient is discharged home on days 2–10. Sore throat persists for 10–14 days. On the 5th–7th day it sharply intensifies, which is associated with the removal of crusts from the walls of the pharynx. Then gradually the pain disappears.

    To relieve suffering, the patient is given intramuscular injections of analgesics. Antibiotics are indicated for several days after surgery.

    Home care

    A white or yellowish coating appears on the operated surface, which completely disappears after the surgical wounds heal. It is prohibited to gargle and disinfect the throat while plaque remains.

    Within two weeks after surgery, the patient is recommended to:

    • talk less
    • do not lift heavy objects,
    • eat only soft, cool foods (vegetable and meat purees, soups, yoghurts, cereals),
    • drink more fluids
    • do not visit the bathhouse, solarium, do not fly by plane,
    • brush your teeth and rinse your mouth with caution,
    • take only cool showers,
    • drink painkillers (paracetomol-based drugs). It is forbidden to take ibuprofen or aspirin, as they increase the risk of bleeding.

    The sense of taste may be impaired for several days after the procedure.

    The recovery period after tonsil removal takes about 2–3 weeks. By the end of the third week, the wounds are completely healed. In place of the tonsils, scar tissue is formed, covered with a mucous membrane. The patient is allowed to return to his normal lifestyle.

    Possible complications

    Negative consequences of tonsil removal in adults include:

    • Risk of bleeding within 14 days after surgery. If drops of blood appear in the saliva, the patient is advised to lie on his side and apply an ice pack to his neck. If the bleeding is intense, you need to call an ambulance.
    • In very rare cases (no more than 0.1%), a change in voice timbre is possible.

    Tonsil removal: pros and cons

    Many patients have an ambiguous attitude towards the appointment of tonsillectomy. It is confusing to hear that the palatine tonsils are an important organ of the immune system, the removal of which leads to the development of respiratory tract infections and an increase in the frequency of colds. Fearing complications, some patients refuse to undergo surgery.

    However, doctors are in a hurry to reassure them: a tonsillectomy cannot affect the immune defense of an adult. The fact is that already in adolescence, the tonsils cease to be the only filter against the penetration of bacteria and viruses. The sublingual and pharyngeal tonsils come to their aid. After surgery, these lymphoid formations are activated and take over all the functions of the removed organs.

    But the preservation of tonsils in the presence of indications for their elimination threatens the development of serious health problems. Inflamed tissues lose their protective properties and turn into a breeding ground for infection. In such a situation, refusing to remove them means dooming yourself to much more dangerous pathologies, including diseases of the heart, kidneys and joints. In women, the onset of chronic tonsillitis can negatively affect reproductive function.

    The risks of the operation are assessed in each specific case individually. Obstacles to its implementation may include:

    • vascular diseases that are accompanied by frequent bleeding and cannot be cured (hemophilia, Osler's disease),
    • severe diabetes mellitus,
    • tuberculosis,
    • stage III hypertension.

    Such patients may be indicated for an intermediate procedure – laser lacunotomy. Micro-incisions are made on the tonsils using an infrared ray, through which the purulent contents flow out.

    Temporary contraindications to tonsillectomy are:

    • menstruation period,
    • untreated caries,
    • inflammation of the gums,
    • acute infectious diseases,
    • last trimester of pregnancy,
    • exacerbation of tonsillitis,
    • exacerbation of any other chronic disease.

    Source: http://otolaryngologist.ru/932

    Tonsil removal for children and adults - reviews from patients. Tonsillectomy surgery - indications and consequences

    The tonsils (tonsils) play a protective role in the body. A person inhales a lot of microbes with air, and the task of the tonsils is to retain a significant part of them. The tonsils synthesize cells involved in the circulatory system. Many people try to solve the problem of tonsillitis with surgery. Is surgery justifiable?

    Removal of tonsils - pros and cons

    Previously, surgery to remove tonsils for chronic tonsillitis was performed on everyone. During the study, American doctors proved that tonsils are not useless organs that can be removed without consequences. The recesses in the tonsils are a kind of laboratory in which a number of functions occur:

    • food and air analysis;
    • the production of protective proteins as a result of the body’s reaction to pathogens.

    Surgery to remove the tonsils (tonsillectomia) reduces the body's defenses and reduces resistance to infections and diseases. The table presents three arguments that will help you understand why in some cases you need to refuse the operation:

    Why are tonsils removed?

    Frequent outbreaks of sore throat and tonsillitis contribute to the accumulation of infections on the pharyngeal tonsils, which undergo scarring. The answer to the question and the reasons why tonsils are cut out are clear. To prevent germs from sore throat from spreading to the lungs and bronchi, doctors eliminate the chronic source of infection. The tonsils affected by the disease do not act as a protective organ, but form a site for the development of microbes, the presence of which in the body affects other internal organs.

    Is it worth removing tonsils?

    Even knowing all the disadvantages of surgical intervention based on reviews, it is impossible to reliably determine whether the tonsils need to be removed. The following doctors can discuss indications for surgery with you:

    List of cases when you may be prescribed surgery:

    1. A person with a sore throat has developed sepsis or jugular vein thrombosis, group A beta-hemolytic streptococcus. If treatment with antibiotics is not possible due to severe disease (abscess on the throat, high fever, suppuration of the tonsils) or allergies, then surgery may be the only way out .
    2. When conducting special tests to determine the reactions occurring in the mouth with the participation of the tonsils, it turned out that they do not respond to stress. If there is insufficient secretion of protective proteins with saliva, the operation will prevent chronic tonsillitis, rheumatism, and kidney disease.
    3. Pathological changes in the tonsils. If the body is susceptible to attacks of sore throat, then surgery is not necessary. However, as a result, the connective tissue can become lymphoid and become a collection site for microbes.

    Tonsil removal - consequences

    If surgery to remove the tonsils could not be avoided, then after the procedure the protection in the pharynx area disappears. This place becomes susceptible to viruses. Other consequences of tonsil removal: weakened immunity, pain for a week after removal, swelling of the larynx, an open wound where the tonsils were torn out, general stress for the body. Antibiotics are prescribed to protect the injured area from bacteria. In rare cases, bleeding after surgery is possible in people with rheumatism.

    Indications for tonsillectomy

    Five years ago, tonsillectomy was considered commonplace. Today, a doctor can suggest removing tonsils only when health problems cannot be solved in a non-surgical, “peaceful” way. Qualified specialists give their indications for tonsil removal in adults when there is no other option. This:

    • the appearance of chronic tonsillitis and its exacerbation due to constant tonsillitis;
    • tonsillitis with complications, including diseases of the nervous system, rheumatism, diseases of the thyroid gland, kidneys, heart, infectious nonspecific polyarthritis;
    • the formation of purulent abscesses that affect the larynx, phlegmon of the neck, paratonsillar (peritonsillar abscess);
    • phlegmonous tonsillitis (intratonsillar abscess);
    • tonsillitis occurs more than 5 times a year with poor health and high temperature;
    • neoplasms of the palatine tonsil;
    • obstructive sleep apnea syndrome – snoring, difficulty breathing;
    • there was a sharp weakening of immunity;
    • uncomplicated tonsillitis does not respond to conservative treatment methods.

    Contraindications to tonsil removal

    The need for tonsillectomy can be finally determined by a general practitioner (pediatrician) together with an ENT doctor based on the medical history and assessment of local changes. To find out whether removal surgery can be performed, the patient is prescribed a comprehensive examination:
    1. general urine analysis;
    2. biochemical and general blood test;
    3. determination of blood clotting time, coagulogram.

    Contraindications to tonsillectomy are divided into temporary (relative) and absolute. The latter include:

    • diabetes mellitus (severe form);
    • hemorrhagic diathesis, acute and chronic leukemia;
    • severe neuropsychiatric diseases may prevent safe surgery;
    • diseases of the heart, kidneys, lungs and liver in the stage of decompensation;
    • abnormalities of the vessels of the pharynx (aneurysm, submucosal pulsation of the vessel);
    • active form of pulmonary tuberculosis. Find out in more detail what are the signs of pulmonary tuberculosis in adults.

    Temporary contraindications include:

    • period of polio and epidemic outbreaks of influenza;
    • acute infectious diseases or prodromal signs of childhood infections;
    • tuberculous bronchoadenitis and tuberculous intoxication;
    • pustular skin diseases;
    • dental caries;
    • severe ketonuria in patients with diabetes mellitus;
    • exacerbation of chronic inflammatory diseases of internal organs;
    • acute dermatitis or chronic dermatitis in the acute stage;
    • menstruation.

    Tonsil removal methods

    Modern otolaryngologists provide a wide range of tonsillectomy techniques. Methods for removing tonsils differ not only in price, but also:

    1. method of influence;
    2. degree of tissue trauma;
    3. volumes of blood loss;
    4. severity of pain after surgery;
    5. recovery period.

    The attending physician will tell you which of the following methods should be chosen in each specific case:

    • laser removal of palatine tonsils;
    • surgical intervention - a classic operation to cut out the tonsils;
    • coblation – removal using the cold plasma method;
    • radio wave tonsillectomy;
    • microdebrider technology;
    • cauterization of tonsils with electric current (electrocoagulation);
    • cryofreezing (cryodestruction).

    Laser tonsil removal

    In addition to the old method of removing tonsils by cutting, there are modern ones, including laser tonsillectomy. Why is the use of a laser scalpel considered effective? The device has a destructive effect on tissue through unidirectional radiation with the same wavelength. The effect caused depends on the length. The sintering effect of the laser eliminates the risk of bleeding. Among the types of laser removal there are:

    1. Complete removal of the tonsils (radical tonsillectomy), in which they can no longer grow.
    2. Trimming only the top layers (laser ablation).

    Different types of lasers are used:

    • if most of the tonsil is affected, a fiber-optic laser is used;
    • if foci of inflammation are detected inside, they are treated with a holmium laser;
    • Infrared laser can be used to fasten tissues;
    • The effect of tissue evaporation is produced by a carbon laser, which reduces the volume of the tonsil and the site of infection.

    Surgery to remove tonsils

    An old method of getting rid of persistent sore throat is cutting out the tonsils, which is performed under general anesthesia and permanently eliminates the source of infection and the breeding ground of bacteria. During the operation, the following medical instruments are used: a wire loop or surgical scissors, a scalpel. The disadvantages of this method are:

    • severe pain in the postoperative period (when the tonsils begin to heal);
    • bleeding;
    • decreased ability of the body to protect against bacteria;
    • development of laryngitis, bronchitis, pharyngitis;
    • allergies.

    Removal of tonsils using cold plasma method

    Coblation is the removal of tonsils using a cold plasma device (coblator), which converts electrical energy into a plasma flow. All this is produced by two electrodes and the electrolyte located between them. The current travels along a short path from minus to plus due to the potential difference that exists between the electrodes. The electrolyte (electrically conductive liquid) is saline solution on the tonsil.

    Plasma formation occurs due to the ion flow formed between the anode and cathode. There is enough energy and plasma to break bonds in organic compounds, and the temperature does not exceed 60 degrees. Removing tonsils using the coblation method means their cold destruction. Soft tissues break down into nitrogen compounds with low molecular weight, carbon dioxide, and water, so they can be dissected or removed volumetrically.

    Radio wave tonsillectomy

    How does the radio wave method of tonsil removal work? The radio signal transmitted by the electrode “evaporates” the intracellular fluid and causes tissue dissection. High-frequency waves are absorbed by the intracellular fluid, due to which the radio wave method of tonsillectomy reduces the chance of damage to adjacent tissues and organs. Among the advantages of this method are the following:

    • the tissues are slightly damaged during the cut;
    • the process of tissue regeneration and restoration is accelerated;
    • minimal risk of complications after surgery;
    • No scars form at the removal site.

    Electrocoagulation of tonsils

    Excision of tonsil tissue using high frequency electric current is called tonsil electrocoagulation. This method is considered an undesirable method of removal due to the consequences that may arise in the postoperative period as a result of the effect of current on surrounding tissue. The procedure is carried out using a device that is heated with electric current to 400 degrees. When tissue is charred, the amount of blood loss is minimal, but the burn after this method will take a long time and be painful to heal.

    Cryodestruction of tonsils

    In otolaryngology, cryofreezing of the tonsils is increasingly used by modern doctors. How does freezing tonsils with liquid nitrogen work? Under the influence of cold, pathogenic microorganisms are destroyed, and when frozen, the affected areas of tissue die. The targeted action of cold allows you to preserve healthy parts of the tonsils, which are necessary for the production of immune cells, providing local immunity and protection from viruses and microbes entering the body.

    How tonsils are removed

    In medicine, the task of removing tonsils is considered a simple operation. To relieve pain during the procedure, anesthesia chosen by the doctor is used. After the anesthesia takes effect, cutting or excision of diseased tissue begins using the chosen method. Once the removal is complete, the patient will be turned on his right side and an ice pack will be placed on his neck to reduce blood loss. After surgery, the attending physician prescribes antibiotics to prevent infection from entering the open wound.

    How to remove tonsils in adults

    To avoid bleeding, 14 days before surgery, the doctor prescribes medications that increase blood clotting. For a month, you need to stop taking medications such as ibuprofen and aspirin. The specialist decides how the tonsils will be removed: partially or completely. In cases of severe hypertrophy of lymphoid tissue, partial removal can be performed. On the day of surgery, you need to stop eating, drinking juices and dairy products 6 hours before the procedure, and stop drinking water 4 hours before the procedure.

    Removal of tonsils in adults is done under local anesthesia. 30 minutes before the start of the operation, the patient is given an intramuscular injection with a sedative. Lidocaine (an anesthetic) is injected into the tissue around the tonsils. The patient is transferred to the operating room and placed on a chair. The damaged organs are removed through the mouth without making any incisions on the chin or neck.

    Tonsillectomy in children

    The time for adenotonsillotomy in a child depends on the method. For example, the classic removal of tonsils in children takes about an hour, and the cryodestruction procedure takes a few minutes. The difference between a pediatric procedure and an adult one is the anesthesia, from which children will wake up when everything is over. How are tonsils cut out? The operation is carried out in several stages:

    1. Use of anesthesia: children are prescribed inhalation or mask general anesthesia. The child's consciousness turns off the gas coming through the mask.
    2. The tonsils are removed completely using the selected method or leaving healthy cells.
    3. The child is removed from the state of anesthesia.

    Tonsillectomy - postoperative period

    If after the operation a yellowish or white coating has formed at the removal site, then there is no need to worry: when the surgical wound heals, everything will look normal. However, it should be remembered that while plaque is present, it is forbidden to disinfect and gargle. The fastest recovery after tonsillectomy and rehabilitation will occur if the patient adheres to the following recommendations for 14 days:

    • talk less;
    • do not lift heavy objects;
    • eat soft, cool food and follow a diet;
    • drink plenty of water, try to avoid coughing;
    • no smoking;
    • refuse solarium, bathhouse;
    • do not fly by plane;
    • brush your teeth with care;
    • take a cool shower;
    • for pain relief, take medications with paracetamol;
    • Do not take aspirin and ibuprofen (bleeding may occur).

    What can you eat after tonsil removal?

    After the operation, on the first day the patient is strictly forbidden to eat anything, but can drink water. Meals after tonsillectomy on the second day should include cool foods, liquid cereals, vegetable and meat purees, soups, yoghurts, and ice cream. For 4 days you need to follow a diet after tonsillectomy and exclude hot or warm foods. The wound heals in about a week, but if tissue restoration is not observed within the specified period, you should consult a doctor. After complete regeneration and with the permission of the doctor, you can return to a normal diet.

    Complications of tonsillectomy

    There are many reviews written on Dr. Komarovsky’s website that removal does not bring consequences. Complications after surgery act only as an opportunity for the development of illnesses. The consequences are not at all necessary. The risks of complications can be minimized if you contact a qualified specialist who will help you choose the removal method for a particular patient, taking into account the characteristics of the medical history.

    Possible complications after tonsil removal in adults:

    1. The bleeding that begins does not go away due to an improper coagulation system. To avoid this phenomenon, the patient should have their blood clotting parameters checked before surgery and, if necessary, postpone the operation.
    2. Complications of an infectious nature due to the spread of purulent infection through the lymphatic and blood vessels. This can happen if a person has a severely reduced immune system, so tonsillectomy is not prescribed for patients with cancer, AIDS, or during acute bacterial or viral infections.
    3. The development of allergic reactions to drugs that are used as pain relievers (anesthetics). Before surgery, people predisposed to allergies take a course of antihistamines.
    4. If laser surgery or electrocoagulation is carried out carelessly, a burn to the mucous membrane and soft tissues is possible.

    Tonsillectomy price

    In Moscow, the price for adenoid removal varies depending on the prestige of the clinic and hospital, the professionalism of the doctors, and the chosen method of tonsillectomy. In some institutions, they will not only perform the operation, but you can also order a room and be under the supervision of doctors during the postoperative period, which will help reduce the risk of complications after the procedure. How much does it cost to remove tonsils in Moscow, see the table:

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    Video: How tonsils are removed

    Reviews

    Afanasy, 24 years old

    I underwent removal under local anesthesia, although the doctor insisted on general. I regretted the money, but not myself: I saw how the procedure took place, the pain was more moral than physical. But the operation was beneficial; I have not had a sore throat for a long time.

    Starting at the age of 12, I suffered from chronic tonsillitis. Doctors suggested cutting out the tonsils surgically using a scalpel. I was very afraid and suffered for many years, but then a laser method for getting rid of adenoids appeared. The operation is completely painless, but after it there is pain for a week.

    The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.

    Source: http://sovets.net/9500-udalenie-mindalin.html