Posts

Nose Aesthetic (Rhinoplasty, Nose Job) in Turkey

Tonsillectomy, Adenoidectomy and Ear Ventilation Tube Insertion Operations

Image
Three common operations in children: tonsil removal operation, adenoid removal surgery, tympanostomy tube placement
In children with tonsil and adenoid hypertrophy for a long time, middle ear fluid accumulation disease (serous or effusive otitis media) may be present due to poor functioning of the eustachian tube that ventilates the middle ear and opens into the nasal region. In the event that medical treatment of middle ear fluid does not improve, fluid accumulation in the middle ear (chronic serous otitis media) and collapse of the eardrum can be placed in addition to tonsil and adenoidectomy surgery. These tubes can be of very different kinds and sizes. Depending on the condition of the eardrum of the patient, hearing loss and the shape of the fluid accumulated in the middle ear, different types of tubes can be used for several months to several years.

Adenoidectomy is performed under general anesthesia. When the patient's mouth is open, the adjacent nasal tissue is scraped wi…

Tonsil Size Grading Scale and Tongue Position Grading System

Image
Clinical Grading of Tonsillar Size and Tongue Position Tonsillar Size Scoring System
Tonsils can be scored according to their size. Especially in patients with sleep apnea syndrome, disease severity increases as tonsil scores increase. The tonsil size scoring system, which is described in the photograph and defined at scores ranging from zero to four, is used in patients with sleep apnea and for pre-anesthetic evaluation. Tonsillectomy in patients with high tonsillectomy surgery has important health benefits.
As the tonsil size increases, sleep apnea may become more severe! As the size of the tonsils increases, the cross-sectional area of the upper airway decreases, so symptoms of sleep apnea may occur or the number of existing sleep apnea attacks may increase. Abnormal increase in sleep apnea symptoms may occur, especially in patients with airway obstruction at the tongue base area.
The Friedman Tongue Position (FTP) Grading System
According to the Friedman Tongue Position (FTP) Sco…

Tonsillectomy Techniques

Image
Tonsil Removal Surgery Techniques
Tonsil surgery was first performed by the Roman surgeon Celsus and described a technique of tearing, pulling with hook and cutting with scalpel.

Today, many tonsillectomy techniques have been described and many surgeons can still use scalpel during tonsillectomy. Tonsil surgery techniques can be listed as follows:

Cold knife technology Removal of tonsils using a scalpel. This technique is applied especially in young patients and under general anesthesia conditions. Although postoperative recovery is rapid, the risk of bleeding may be high.
Electrocautery-assisted tonsillectomy Electrocautery separates the tonsil tissue from the external tissue. This technique causes less blood loss than the cold knife technique. This may cause thermal damage to the tissue outside the tonsils. Postoperative pain may also be high due to heat damage.
Harmonic scalpel technique This medical device is in the form of a blade with 55,000 vibrations of ultrasonic energy per …

Definition of Tonsillectomy Operation

Image
Tonsil Removal Surgery

Tonsil removal surgery or tonsillectomy is the procedure of complete removal of tonsils with capsules. In this surgical procedure, dissection is performed from the space (peritonsillar area) between the capsule of the tonsils and the outer muscle wall.

Many different techniques have been described for tonsillectomy. There are different tonsillectomy techniques such as laser tonsil surgery, thermal welding method, bloodless and knife-free tonsil surgery, coblation method, radiofrequency reduction and classical dissection method.
Tonsil size and sleep apnea syndrome
Tonsils are an element of the immune system. It is the member of the "Waldeyer's Lymphatic Ring" in our throat, which has the task of defending the body against microbes. In addition to their duties in terms of immunity, the tonsils located in the respiratory area in the throat region cause many negative health effects when they are larger than normal.


In people with enlarged tonsils, sle…

Voice and Speech Changes After Tonsillectomy

Image
Does tonsillectomy cause voice changes?
After tonsillectomy, patients may have changes in voice and speech.

Patients with large tonsils have a significant increase in airway after surgery. However, there may also be edema and pain in the soft palate and small tongue. Consequently, patients may have difficulty in speaking or changes in voice. Usually after a few weeks this may improve. However, there is also an increase in the distance behind the palate (velopharyngeal space) in children with tonsil and nasal flesh. Therefore, the amount of air to the nose increases when talking (velopharyngeal insufficiency / hypernazality), as well as breathing through the nose, the sinuses can contribute to the shaping of the sound and there may be differences in tone. Within a few weeks after surgery, many troubles will disappear. If the velopharyngeal insufficiency persists, followed by a speech therapist, and re-narrowing of this area can be performed.
How can voice and speech be adversely affec…

Negative Impact of Tonsillectomy on Health

Image
Adverse Effects of  Tonsil Removal Surgery on Health
Early post-operative adverse health effects Early post-operative adverse health effects associated with tonsil surgery can be grouped as follows:
- anesthesia risks
- postoperative pain
- postoperative bleeding.

Bleeding rate in the first 24 hours postoperatively varies between 0.2% and 2.2%.

Apart from these, trauma to the pharynx, larynx and palate area, although rare, may be associated with anesthesia risks such as difficult intubation, laryngospasm, laryngeal edema, aspiration, heart disorders, nausea, vomiting, and pulmonary edema.

Since the operation is performed by opening the mouth, lip injuries and jaw joint injuries can also be seen very rarely.

I have not seen any of the above-mentioned risks and complications, except that only a few patients had minor bleeding.

Children with hypertrophied tonsils and adenoid have long been accustomed to taking small amounts of oxygen. Oxygen may enter the lungs after surgery and may caus…

Why Is Tonsillectomy Performed Frequently?

Image
Tonsil removal surgery frequency Surgical removal of tonsils is called "tonsillectomy". This surgery, which is frequently performed for the treatment of tonsillitis during the years when antibiotics are not widespread, is less applied today for this purpose. However, tonsillectomy is still one of the most common operations.This surgery, which is frequently performed for the treatment of tonsillitis during the years when antibiotics are not widespread, is less applied today for this purpose. However, tonsillectomy is still one of the most common operations.


Between 1915 and 1960, tonsillectomy was the most common surgical procedure in the United States. However, between 1977 and 1989, there was a decrease in the rates of tonsillectomy for the treatment of throat infections. Physicians thought that the sensitivity of the immune system could be reduced and that the tonsils might no longer be a problem in the coming years. The frequency of tonsillectomy has increased again in t…

Local Anesthetic Infiltration Before Revision Nose Surgery Can Provide Information About The Difficulty Of The Surgery!

Image
Injected local anesthetic drug into the skin of the nose and it comes out again from the nose
Revision rhinoplasty operations are operations in which many details such as "opening a surprise box" can be understood during surgery and sometimes complicated procedures may be required. In the photograph above and in the video below, the patient had undergone "alar base resection" operation for the purpose of nasal esthetics twice and constriction of the nasal wings at the same time, where the local anesthetic drug can be injected very hard under the skin before the operation and it is seen that it comes out again from the nose.


In the video above, the patient had previously reported infection and bleeding in areas where the injected drug was released. In the intra-nasal examination, it can be predicted that the line-shaped incision area of ​​the left nose wing is very thin and there may be tissue reaction due to permanent suture materials; it is not easy to understand …

Indications for Tonsillectomy

Image
Who should do tonsil surgery?
In the last published guide, the patients who should undergo tonsillectomy (indications for tonsillectomy) are as follows:

- Recurrent tonsillitis

. Inflammation of tonsils 7 times a year and more
. Inflammation of the tonsils at least 5 times in each year in the last 2 years
. At least 3 times each year in the last 3 years to have tonsillitis

Among the children in this group, especially with throat cultures, surgery can be planned at an earlier stage in case of throat infections due to A ß-hemolytic streptococcal bacteria despite treatment.

This long-term indication of recurrent throat infections can be changed to the following three conditions:

1. Multiple antibiotic allergies (as a complication of tonsillitis)

2. In the presence of a specific clinical picture such as PFAPA (periodic fever, aphthous stomatitis, pharyngitis and adenitis). In this picture, tonsil and nasal surgery is the most effective treatment (recurrent episodes of severe tonsillitis …

General Information About Tonsillectomy

Image
Tonsil removal surgery Tonsil removal surgery or tonsillectomy is one of the most common surgical procedures in the world. Tonsils are taken because they cause problems related to sleep breathing disorders and recurrent throat infections.
Tonsillectomy is not appropriate in very hot weather!
In each patient, surgery decision is made considering the benefits and harms of tonsillectomy. Due to the increased risk of bleeding due to dilation of the vessels in hot air and the healing of the patient due to sweating loss of water adversely affected, tonsil surgery is not recommended in the summer months. This surgery can be performed in other seasons.



Hypertrophic tonsils and adenoids impairs sleep quality Tonsil and adenoid problems can affect children's lives as well as different problems depending on the growth can cause. For example, the most common simple growths and / or frequent recurrent infections can prevent the child from going to school. However, due to the obstructive natur…

What Is The Minimum Age For Tonsillectomy Operation?

Image
Minimum age for tonsil removal surgery
Tonsil surgery according to the old sources, under 3 years and 15 kg weight was reported to be inconvenient. In addition to developing anesthesia techniques, as a result of the understanding of the risks of severe sleep apnea syndrome in children with severe tonsil and nasal enlargement, tonsil and nasal surgery was started in children under 3 years of age.

On the subject of the American Academy of Otolaryngology-Head and Neck Surgery (www.entnet.org), the latest guidelines for the treatment of tonsillectomy for families and physicians (Clinical Practice GuidelineTonsillectomy) In Children - http://www.entnet.org/HealthInformation/upload/CPG-TonsillectomyInChildren.pdf), tonsillectomy can be performed from the age of 1.

In current treatment protocols, it is best to expect patients under 3 years of age who do not have severe respiratory arrest due to tonsils or who do not have frequent tonsils. There is no definite upper age limit for tonsil surg…