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Tonsillectomy

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What are tonsils and what is their role?

Palatine tonsils are lymphoid tissue and together with the adenoids and the lingual tonsil operate as a filter, retaining microorganisms. Specifically, they are two small glands, located at the entrance of the airways.
Their main role is:

  • To remove various germs from the body
  • To produce antibodies, enhancing the body’s defences and therefore, fighting infections.

Tonsillectomy: When should it be done

The main indications for tonsillectomy are:

  • When there are recurrent episodes of tonsillitis in a year (3 or more)
  • When, even once, a peritonsillar abscess has occurred
  • When the inflammation affects neighbouring organs
  • In cases of intense snoring and apnoea

Up to what age can patients undergo a tonsillectomy?

In any case, as the role of tonsils up to the 2nd year of age is extremely important because they identify the nature of antigens and provide the body with the “memory” for preserving this identification process for life, tonsillectomy is not allowed before the age of 3.

How is the tonsillectomy operation performed?

To perform the operation it is necessary to conduct a pre-operative assessment, to allow adult or child patients undergo general anaesthesia; then, the surgery is performed through the mouth.

There are three ways to perform tonsillectomy:

  • Extracapsular tonsillectomy, during which the entire tonsil and the surrounding fascia are prepared anew. This type of tonsillectomy, takes about 45 minutes and requires overnight hospitalisation, for patient monitoring.
  • Intracapsular tonsillectomy, which does not remove the entire organ and does not require hospitalisation.
  • Cryptolysis, is a process whereby the objective of the attending physician is to reduce the volume of the tonsils, without affecting the crypts, while performing a thorough cleansing of the area.

What mainly applies today is the removal with use of radio frequencies.

What should patients do postoperatively?

First, what patients should definitely do after surgery (hospitalization period: 1 day), is to follow closely the surgeon’s instructions. If the instructions are followed, the healing period will be extremely smooth and painless.
Furthermore, patients need to receive their painkillers and antibiotics with exact precision, to achieve maximum effect and action. Regarding their diet, patients should note that it is crucial that they eat soft foods for the first few days after surgery. Most patients are relieved with an ice cube in their mouth and want their food cold. It is stressed that drinking and smoking is prohibited, at least for the first ten days after surgery.
Finally, patients can return to work after a period of four days and it is necessary to avoid intense physical activity and sports for 15 days.

FAQs about tonsillectomy

Which cases require tonsil removal (tonsillectomy)?

  • When there are several tonsillitis episodes (four or more a year) or less, but quite serious.
  • When there are several tonsillitis episodes (four or more a year) or less, but quite serious.

Note that tonsil swelling mainly occurs in children, while in adults recurrent tonsillitis and peritonsillar abscess are more common.

  • In patients who developed peritonsillar abscess, tonsil removal is preferred to prevent its future recurrence.
  • When the inflammation affects neighbouring organs (ears, sinuses, lungs).
  • When patients snore heavily or experience apnoea due to large tonsils.
  • If cancer is suspected – a type of cancer which is extremely rare.

What are the symptoms of tonsil inflammation or hypertrophy?

  • Easy fatigue
  • Pains in the musculoskeletal system
  • Swollen lymph nodes in the neck
  • Bad breath
  • Headache
  • Persistent cough
  • Low-grade fever

What is tonsillitis?

It is the inflammation of tonsils. Tonsillitis occurs when there is a factor impairing the defensive ability of the immune system. Typical examples are the simple viruses, namely colds. Tonsillitis can be either acute, lasting several days or weeks, or chronic, lasting months. A development of tonsillitis is the peritonsillar abscess.

What is peritonsillar abscess?

Peritonsillar abscess is the term used to refer to a situation in which pus accumulates between the pharyngeal wall and the tonsil. Pus collection is considered extremely harmful to the smooth functioning of the body, as it causes respiratory distress to the patient, because it tends to grow deep in the throat.
Usually, the only way to definitively treat peritonsillar abscess is surgical incision and the subsequent tonsillectomy, after remission of the acute inflammation.

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ANATOLI PATARIDOU

Head & Neck Otolaryngologist - Pedriatric ENT
Scientific Associate of Ygeia - Mitera Hospital