Definition of Tonsillectomy Operation

Tonsil Removal Surgery

Definition of Tonsillectomy Operation

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

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.

Tonsil size and obstructive sleep apnea syndrome

In people with enlarged tonsils, sleep quality decreased as the size of the tonsils increased. It has been shown that in children with large tonsils and those with sleep apnea, serious increase in blood pressure during sleep, increase in stress hormones and many negative effects are associated.

The reason for the increase in the frequency of tonsillectomy in recent years is to understand the relationship between tonsil growth and sleep apnea more clearly.

Tonsillectomy and adenoidectomy
In the photo above, with severe sleep apnea and will be in contact with each other so that large tonsils (kissing tonsils) pre-operation and post-operative images of the patient's tonsils are available.  We performed tonsillectomy operation and classical adenoidectomy operation with a thermal welding device.  The anterior and posterior folds were sutured with 4/0 vicryl (purple threads in the bottom photo)

Does the body need tonsils?

Like every organ in our body, it had some tasks in the tonsils, but this is not a sine qua non function. Therefore, tonsil and adenoid operations constitute the majority of the surgical interventions performed especially in pediatric age in the world. The main issue here is the necessity of deciding whether to take tonsils or adenoid for that patient for sound, evidence-based medical reasons.

Tonsils should be taken? Is tonsil always taken with adenoid?

Tonsil operations should be performed when necessary. Since tonsil adenoid-like lymphoid tissues are present, especially in pediatric patients, tonsil problems are often associated with adenoid problems, and they should usually be taken together when an operation is needed. Surgical removal of these lymphoid tissues may usually be required for two reasons. The first is that the tonsil and adenoid increase in size and obstruct the airway, and the second is frequent inflammation. The tonsils are large; swallowing, feeding and speech problems. Food accumulated on the tonsils can also create bad breath. The large adenoid tissue causes nasal congestion. It causes open mouth sleep and snoring in these patients. In addition, the large and obstructive adenoid can cause developmental disorders in the face and jaw bones, causing adenoid face appearance, fluid accumulation and hearing loss in the middle ear, sinusitis, nasal discharge and pharyngitis and cough. Also, recurrent tonsillitis can cause problems in the heart, joints and kidneys. In such cases, tonsillectomy and adenoidectomy operations should be planned.

Do tonsils cause more problems depending on age?

Tonsil problems are usually reduced after childhood. As the airway diameter increases with age, obstructive conditions are seen less and with the development of the general immune system with age, tonsil infections may decrease with age. However, adult tonsil infections are much more severe, long recovery time leads to job losses and longer health problems.

Is there a season for tonsillectomy?

Tonsil operations can be performed in all seasons, but very hot days of summer are not suitable. Due to postoperative pain, fluid intake of young children may be restricted and complication rates may increase. Usually winter and spring are more suitable months.

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Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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