Throat with Tonsils

Throat after tonsillectomy

A tonsillectomy is a surgical procedure in which the tonsils are removed. Sometimes the adenoids are removed at the same time. Image File history File linksMetadata Download high-resolution version (1279x975, 321 KB) Taken by me, no usage restrictions. ... Image File history File linksMetadata Download high-resolution version (1279x975, 321 KB) Taken by me, no usage restrictions. ... The Palatine tonsils. ... Image File history File links Uvula_without_tonsils. ... Image File history File links Uvula_without_tonsils. ... Surgical procedures have long and possibly daunting names. ... This article or section contains too much jargon and may need simplification or further explanation. ... Adenoids (or pharyngeal tonsils, or nasopharyngeal tonsils) are a mass of lymphoid tissue situated at the very back of the nose, in the roof of the nasopharynx, where the nose blends into the mouth. ...

Reasons for tonsillectomy

Tonsillectomy may be performed when the patient:

• Experiences frequent bouts of acute tonsillitis. The number requiring tonsillectomy varies with the severity of the episodes. One case, even severe, is generally not enough for most surgeons to decide tonsillectomy is necessary.
• Has chronic tonsillitis, consisting of persistent, moderate-to-severe throat pain.
• Has multiple bouts of peritonsillar abscess.
• Has sleep apnea (stopping or obstructing breathing at night due to enlarged tonsils or adenoids)
• Difficulty eating or swallowing due to enlarged tonsils

Tonsillitis is an inflammation of the tonsils in the mouth and will often, but not necessarily, cause a sore throat and fever. ... In medicine, a chronic disease is a disease that is long-lasting or recurrent. ... Tonsillitis is an inflammation of the tonsils in the mouth and will often, but not necessarily, cause a sore throat and fever. ... Sleep apnea, sleep apnoea or sleep apnœa is a sleep disorder characterized by pauses in breathing during sleep. ...

Common Causes and Demographics

Infections requiring tonsillectomy are often a result of Streptococcus ("strep throat"), but some may be due to other bacteria, such as Staphylococcus, or viruses. However, the etiology of the condition is largely irrelevant in determining whether tonsillectomy is required ^[1]. Streptococcus is a genus of spherical shaped Gram-positive bacteria, belonging to the phylum Firmicutes[1] and the lactic acid bacteria group. ... Strep throat (or Streptococcal pharyngitis, or Streptococcal Sore Throat) is a form of Group A streptococcal infection that affects the pharynx. ... Phyla/Divisions Actinobacteria Aquificae Bacteroidetes/Chlorobi Chlamydiae/Verrucomicrobia Chloroflexi Chrysiogenetes Cyanobacteria Deferribacteres Deinococcus-Thermus Dictyoglomi Fibrobacteres/Acidobacteria Firmicutes Fusobacteria Gemmatimonadetes Nitrospirae Omnibacteria Planctomycetes Proteobacteria Spirochaetes Thermodesulfobacteria Thermomicrobia Thermotogae Bacteria (singular, bacterium) are a major group of living organisms. ... Species S. aureus S. caprae S. epidermidis S. haemolyticus S. hominis S. lugdunensis S. pettenkoferi S. saprophyticus S. warneri S. xylosus Staphylococcus (in Greek staphyle means bunch of grapes and coccos means granule) is a genus of Gram-positive bacteria. ... This article is about biological infectious particles. ... This article is about the medical term. ...

Most tonsillectomies are performed on children, although many are also performed on teenagers and adults. The number of tonsillectomies in the United States has dropped significantly from several million in the 1970s to approximately 600,000 in the late 1990s^{[citation needed]}. This has been due in part to more stringent guidelines for tonsillectomy and adenoidectomy (see tonsillitis and adenoid). Still, debate about the usefulness of tonsillectomies continues. Not surprisingly, the otolaryngology literature is usually pro-tonsillectomy, whereas the pediatric literature has the opposing view ^{[citation needed]}. Enlarged tonsils are being removed more often among adults and children for sleep apnea (airway obstruction while sleeping), snoring, and upper airway obstruction. Children who have sleep apnea can do poorly in school, are tired and fatigued during the day, and have some links to ADHD ^{[2] [3]}. The 1970s decade refers to the years from 1970 to 1979, also called The Seventies. ... For the band, see 1990s (band). ... Tonsillitis is an inflammation of the tonsils in the mouth and will often, but not necessarily, cause a sore throat and fever. ... Adenoids (or pharyngeal tonsils, or nasopharyngeal tonsils) are a mass of lymphoid tissue situated at the very back of the nose, in the roof of the nasopharynx, where the nose blends into the mouth. ... Otolaryngology is the branch of medicine that specializes in the diagnosis and treatment of ear, nose, throat, and head & neck disorders. ... Pediatrics (also spelled paediatrics or pædiatrics) is the branch of medicine that deals with the medical care of infants and children. ... DISCLAIMER Please remember that Wikipedia is offered for informational use only. ...

Tonsillectomy in adults is more painful than in children, although each patient will have a different experience. In adults it can be extremely painful often referred to as more painful than child birth. Post-operative recovery can take from 10 up to 20 days, during which narcotic analgesics are typically prescribed. A normal diet (e.g., toast) is strongly recommended, as a normal diet will help to clean the wound and stop bleeding from occurring. However, spicy foods should be avoided. Many people believe that you should eat soft foods (e.g., ice cream) after having your tonsils removed, as it is soothing and relieves the pain, but this is strongly discouraged, since dairy products tend to coat the throat. This can cause intensive bleeding and slows the healing process. Proper hydration is also very important during this time, since dehydration can increase throat pain, leading to a vicious cycle of poor fluid intake. At some point, most commonly 7-11 days after the surgery (but occasionally as long as two weeks (14 days) after), bleeding can occur when scabs begin sloughing off from the surgical sites. The overall risk of bleeding is approximately 1-2% higher in adults ^[4]. Approximately 10% of adult patients develop significant bleeding at this time. The bleeding might naturally stop quickly, or else mild intervention (e.g., gargling cold water) could be needed. Otherwise, a surgeon must repair the bleeding immediately by cauterization, which presents all the risks associated with emergency surgery (most having to do with the administration of anesthesia on a patient whose stomach is not empty). Various procedures are available to remove tonsils, each with different advantages and disadvantages. Children and teenagers sometimes exhibit a noticeable change in voice ^[5] after the operation ^{[6] [7]}. 19th century Heroin bottle This article is about the drug classification. ... An analgesic (colloquially known as a painkiller) is any member of the diverse group of drugs used to relieve pain (achieve analgesia). ... Dehydration (hypohydration) is the removal of water (hydro in ancient Greek) from an object. ... In many parts of economics there is an assumption that a complex system of determinants will tend to lead to a state of equilibrium. ... Scab can refer to the following: Look up scab in Wiktionary, the free dictionary. ... Cauterization is a medical term describing the burning of the body to remove or close a part of it. ... Anesthesia or anaesthesia (see spelling differences) has traditionally meant the condition of having the perception of pain and other sensations blocked. ...

Methods of tonsil removal

The first report of tonsillectomy was made by the Roman encyclopedist Celsus in 30 AD. He described scraping the tonsils and tearing them out or picking them up with a hook and excising them with a scalpel. Today, the scalpel is still the preferred surgical instrument of many ear, nose, and throat specialists. However, there are other procedures available – the choice may be dictated by the extent of the procedure (complete tonsil removal versus partial tonsillectomy) and other considerations such as pain and post-operative bleeding. A quick review of each procedure follows: Aulus Cornelius Celsus Aulus Cornelius Celsus (25 BC—50) was a Roman encyclopedist and possibly, although not likely, a physician. ... For other uses, see Scalpel (disambiguation). ... Otolaryngology is the branch of medicine that specializes in the diagnosis and treatment of ear, nose, throat, and head & neck disorders. ... Pain redirects here. ... For other uses, see Bleeding (disambiguation). ...

• dissection and snare method:

Removal of the tonsils by use of a forceps and scissors with wire loop called 'snare' is the most common method practiced by otolaryngologists today. The procedure requires the patient to undergo general anesthesia; the tonsils are completely removed with minimal post-operative bleeding. Otolaryngology is the branch of medicine that specialises in the diagnosis and treatment of ear, nose, throat, and head & neck disorders. ... A patient having his blood pressure taken by a doctor. ... This article or section may be confusing for some readers, and should be edited to be clearer. ...

• Electrocautery: Electrocautery burns the tonsillar tissue and assists in reducing blood loss through cauterization. Research has shown that the heat of electrocautery (400 C) results in thermal injury to surrounding tissue. This may result in more discomfort during the postoperative period.

• Harmonic scalpel: This medical device uses ultrasonic energy to vibrate its blade at 55,000 cycles per second. Invisible to the naked eye, the vibration transfers energy to the tissue, providing simultaneous cutting and coagulation. The temperature of the surrounding tissue reaches 80 C. Proponents of this procedure assert that the end result is precise cutting with minimal thermal damage.

• Radiofrequency ablation: Monopolar radiofrequency thermal ablation transfers radiofrequency energy to the tonsil tissue through probes inserted in the tonsil. The procedure can be performed in an office setting under light sedation or local anesthesia. After the treatment is performed, scarring occurs within the tonsil causing it to decrease in size over a period of several weeks. The treatment can be performed several times. The advantages of this technique are minimal discomfort, ease of operations, and immediate return to work or school. Tonsillar tissue remains after the procedure but is less prominent. This procedure is recommended for treating enlarged tonsils and not chronic or recurrent tonsillitis.

• Thermal Welding: A new technology which uses pure thermal energy to seal and divide the tissue. The resulting absence of thermal spread means that the temperature of surrounding tissue is only 2-3 degrees C higher than normal body temperature. Clinical papers show patients with minimal post-operative pain (no requirement for narcotic pain-killers), zero edema (swelling) plus almost no incidence of bleeding. Hospitals in the US are advertising this procedure as "Painless Tonsillectomy". Also known as Tissue Welding.

• Carbon dioxide laser: Laser tonsil ablation (LTA) finds the otolaryngologist employing a hand-held CO2 or KTP laser to vaporize and remove tonsil tissue. This technique reduces tonsil volume and eliminates recesses in the tonsils that collect chronic and recurrent infections. This procedure is recommended for chronic recurrent tonsillitis, chronic sore throats, severe halitosis, or airway obstruction caused by enlarged tonsils.

  The LTA is performed in 15 to 20 minutes in an office setting under local anesthesia. The patient leaves the office with minimal discomfort and returns to school or work the next day. Post-tonsillectomy bleeding may occur in two to five percent of patients. Previous research studies state that laser technology provides significantly less pain during the post-operative recovery of children, resulting in less sleep disturbance, decreased morbidity, and less need for medications. On the other hand, some believe that children are adverse to outpatient procedures without sedation. Hot cauters were applied to tissues or arteries to stop them from bleeding. ... For other uses, see Burn. ... Human blood smear: a - erythrocytes; b - neutrophil; c - eosinophil; d - lymphocyte. ... Cauterization is a medical term describing the burning of the body to remove or close a part of it. ... Celsius is, or relates to, the Celsius temperature scale (previously known as the centigrade scale). ... Drawing of the structure of cork as it appeared under the microscope to Robert Hooke from Micrographia which is the origin of the word cell being used to describe the smallest unit of a living organism Cells in culture, stained for keratin (red) and DNA (green) The cell is the... Ultrasound is sound with a frequency greater than the upper limit of human hearing, approximately 20 kilohertz. ... Look up vibration in Wiktionary, the free dictionary. ... For other uses, see Eye (disambiguation). ... This article is about the clotting of blood. ... Radio frequency, or RF, refers to that portion of the electromagnetic spectrum in which electromagnetic waves can be generated by alternating current fed to an antenna. ... A scar results from the biologic process of wound repair in the skin and other tissues of the body. ... Tonsillitis is an inflammation of the tonsils in the mouth and will often, but not necessarily, cause a sore throat and fever. ... For other uses, see Laser (disambiguation). ... Carbon dioxide is an atmospheric gas composed of one carbon and two oxygen atoms. ... Infection is also the title of an episode of the television series Babylon 5; see Infection (Babylon 5). ... Halitosis, oral malodor (scientific term), breath odor, foul breath, fetor oris, fetor ex ore, or most commonly bad breath are terms used to describe noticeably unpleasant odors exhaled in breathing – whether the smell is from an oral source or not. ... A minute is a unit of time equal to 1/60th of an hour and to 60 seconds. ... Students in Rome, Italy. ... For other uses, see Child (disambiguation). ... For other uses, see Sleep (disambiguation). ... This article does not cite any references or sources. ...

• Microdebrider: The microdebrider is a powered rotary shaving device with continuous suction often used during sinus surgery. It is made up of a cannula or tube, connected to a hand piece, which in turn is connected to a motor with foot control and a suction device.

  The endoscopic microdebrider is used in performing a partial tonsillectomy, by partially shaving the tonsils. This procedure entails eliminating the obstructive portion of the tonsil while preserving the tonsillar capsule. A natural biologic dressing is left in place over the pharyngeal muscles, preventing injury, inflammation, and infection. The procedure results in less post-operative pain, a more rapid recovery, and perhaps fewer delayed complications. However, the partial tonsillectomy is suggested for enlarged tonsils – not those that incur repeated infections. This article does not cite any references or sources. ...

• Bipolar Radiofrequency Ablation (Coblation): This procedure produces an ionized saline layer that disrupts molecular bonds without using heat. As the energy is transferred to the tissue, ionic dissociation occurs. This mechanism can be used to remove all or only part of the tonsil. It is done under general anesthesia in the operating room and can be used for enlarged tonsils and chronic or recurrent infections. This causes removal of tissue with a thermal effect of 45-85 C. It has been claimed that this technique results in less pain, faster healing, and less post operative care ^[8]. However, review of 21 studies gives conflicting results about levels of pain, and its comparative safety has yet to be confirmed ^[9].

... In medicine, saline is a solution of sodium chloride (a substance also commonly known as table salt) in sterile water, used frequently for intravenous infusion, rinsing contact lenses, and nasal irrigation (or the yogic practice called jala neti). ... Covalently bonded hydrogen and carbon in a molecule of methane. ...

See also

• Tonsil
• Adenoid
• Adenoidectomy

This article or section contains too much jargon and may need simplification or further explanation. ... Adenoids (or pharyngeal tonsils, or nasopharyngeal tonsils) are a mass of lymphoid tissue situated at the very back of the nose, in the roof of the nasopharynx, where the nose blends into the mouth. ... Location of the adenoid Adenoidectomy is the surgical removal of the adenoids. ...

References

1. ^ http://www.ivillage.com/topics/health/0,,232762,00.html
2. ^ Avior G, Fishman G, Leor A, Sivan Y, Kaysar N, Derowe A (2004). "The effect of tonsillectomy and adenoidectomy on inattention and impulsivity as measured by the Test of Variables of Attention (TOVA) in children with obstructive sleep apnea syndrome". Otolaryngol Head Neck Surg 131 (4): 367-71. PMID 15467601. 
3. ^ Ray RM, Bower CM (2005). "Pediatric obstructive sleep apnea: the year in review". Curr Opin Otolaryngol Head Neck Surg 13 (6): 360-5. PMID 16282765. 
4. ^ Windfuhr JP, Chen YS, Remmert S (2005). "Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients". Otolaryngol Head Neck Surg 132 (2): 281-6. PMID 15692542. 
5. ^ http://www.doctorhoffman.com/ta.htm
6. ^ http://aaohns.org/healthinfo/throat/tonsil_procedures
7. ^ http://www.nlm.nih.gov/medlineplus/tonsilstonsillectomy.html
8. ^ Friedman M, LoSavio P, Ibrahim H, Ramakrishnan V (2003). "Radiofrequency tonsil reduction: safety, morbidity, and efficacy". Laryngoscope 113 (5): 882-7. PMID 12792327. 
9. ^ Windfuhr JP (13 April 2007). "[Coblation tonsillectomy: a review of the literature.]". HNO. doi:10.1007/s00106-006-1523-3. PMID 17431570. 

A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

External links

• Insight Into Tonsillectomy and Adenoidectomy
• Tonsillectomy Procedures
• drtbalu otolaryngology on line