TONSILLECTOMY

Tonsillectomy
• tonsillectomy is a surgical procedure in which the tonsils are removed from
either side of the throat.
• The tonsillectomy has been practiced for 3,000 years, with varying popularity
over the centuries.
• The procedure is performed in response to cases of repeated occurrence of
acute tonsillitis or adenoiditis, obstructive sleep apnea, nasal airway
obstruction, snoring, or peritonsillar abscess.
• Sometimes the adenoids are removed at the same time, a procedure called
adenoidectomy.
 Tonsilectomy
INDICATION
• Experiences recurrent infections of acute tonsillitis.
• Has chronic tonsillitis, consisting of persistent, moderate-to-
severe throat pain
• Has multiple bouts of peritonsillar abscess.
• Has sleep apnea
• Has difficulty eating or swallowing due to enlarged tonsils
• Produces tonsilloliths (tonsil stones) in the back of their mouth.
• Has abnormally large tonsils with crypts
 Surgical Procedure
The generally accepted procedure for tonsillectomy involves separating and
removing the tonsils from the subcapsular plane – a fascia of tissue that surrounds
the tonsils. Removal is typically achieved using a scalpel and blunt dissection or
with electrocautery, although harmonic scalpels or lasers have also been used.
Bleeding is stopped with electrocautery, ligation of sutures, and the topical use of
thrombin, a protein that induces blood clotting.
The procedure is carried out with the patient lying flat on their backs, with the
shoulders elevated on a small pillow so that the neck is hyperextended – the so-
called 'Rose' position. A mouth gag is used to prop the mouth open; if an
adenoidectomy is also being performed, the adenoids are first removed with a
curette; the nasopharynx is then packed with sterile gauze. A tonsil is removed by
holding it by the upper part, pulling it slightly medially, and making a cut over the
anterior faucial pillar. After the tonsil is removed from its position, a snare can be
used to make a small cut on the lower portion prior to removal of the tonsil. The
use of electrocautery minimizes the blood loss.
 Post-Operative Care
• Patients should try to get as much fluid down as possible, as it will help speed
recovery. Very cold drinks will help bring down swelling.
• Patients are encouraged to maintain diet of liquid and very soft foods for several
days following surgery.
• Pain following the procedure is significant and may include a hospital stay.
Recovery can take from 10 up to 20 days, during which narcotic analgesics are
typically prescribed.
• Rough textured, acidic or spicy foods may be irritating and should be avoided.
• Proper hydration is very important during this time, since dehydration can
increase throat pain, leading to a vicious cycle of poor fluid intake
Tonsillectomy
Tonsillectomy Surgical Set