A tonsillectomy, according to the American Academy of Otolaryngology-Head & Neck Surgery, is a surgical method that removes the tonsil, including its capsule, by dissecting the peritonsillar gap between the tonsil capsule and the muscle wall. Tonsillectomy is one of the most famous surgical procedures in the United States. Every year, almost 500,000 cases are done on youngsters under the age of 15. Two major causes of this operation are sleep-disordered breathing and recurring throat infections. A tonsillectomy creates several problems that lead to complications including bleeding, velopharyngeal insufficiency, and dehydration. This article discusses the reasons, contraindications, and methods used in tonsillectomy, as well as the role of the inter-professional team in treating these patients before and after surgery. [1]
Why are tonsillectomies performed?
Teens frequently get a tonsillectomy because:
- Their tonsils are so large that they obstruct the airway and make breathing difficult. Swollen tonsils can make it difficult to breathe, particularly when sleeping. When the tonsils obstruct breathing, a person may snore and cease breathing for brief periods while sleeping. This is termed as obstructive sleep apnea. Apnea can cause a person to lose out on good, peaceful sleep and potentially cause health issues.
- Their tonsils are often infected. If a person has a lot of tonsil infections (called tonsillitis), a doctor may advise removing the tonsils. Experts define “a lot” as at least 7 infections per year, more than 5 infections a year for two years in a row, or three infections per year for three years.
What Takes Place Prior to a Tonsillectomy?
If you should stop taking any medications in the week or two before the operation, your doctor will tell you. You’ll also be instructed when you can and cannot eat or drink since your stomach must be empty on the day of the surgery.
What Takes Place during a Tonsillectomy?
While you are under general anesthesia, an ear, nose, and throat (ENT) surgeon will perform the surgery. This means that an anesthesiologist will keep you safe and comfortable while the surgery is performed. The operation is performed with your mouth open. There are no obvious scars or wounds on the skin.
Tonsillectomy surgery is classified into two types:
- Traditional tonsillectomy: Both tonsils are removed fully.
- Intracapsular tonsillectomy: The surgeon removes all of the damaged tonsil tissue while leaving a thin layer to protect the neck muscles underneath. There is a very small risk that the leftover tissue may re-grow or get infected, necessitating another tonsil surgery, although this is uncommon.
If you undergo this sort of surgery, you will:
- Recover quicker
- Have less discomfort
- Need less pain medication
- Have a lesser chance of bleeding
- Be able to eat and drink more easily after the operation
Equipment
The surgical equipment needed for tonsillectomy is determined by the procedure employed. McIvor mouth gag or Crowe-Davis, Allis clamp, no. 12 scalpel, Fisher tonsil knife/dissector, curved Metzenbaum scissors, adenoidectomy curettes, Tyding snares, and a St. Clair-Thompson adenoid forceps are used during cold tonsillectomy. Monopolar cautery is used to do “hot” tonsil surgery. Bipolar radiofrequency ablation (also known as coblation) is another alternative. Mircodebrider methods are also used especially when doing intracapsular tonsillectomies.
