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What is a Tonsillectomy?
McCool Bhuta ENT

What is a Tonsillectomy?

Unfortunately, there may be a time when medical therapy (antibiotics) fails to resolve the chronic tonsil infections that affect your child. In other cases, your child may have enlarged tonsils, causing loud snoring, upper airway obstruction, and other sleep disorders. The best recourse for both of these conditions may be removal of the tonsils and adenoids. The American Academy of Otolaryngology—Head and Neck Surgery recommends that children who have three or more tonsillar infections a year undergo a tonsillectomy; the young patient with a sleep disorder should be a candidate for removal of enlarged tonsils.

 

The tonsillectomy today

The first report of tonsillectomy was made by the Roman surgeon 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, there are several techniques available – the choice may be dictated by the extent of the procedure and other considerations such as pain and post-operative bleeding. A quick review of each procedure follows:

 

Cold knife (steel) dissection:

Removal of the tonsils by use of a scalpel is the most traditional method practiced by otolaryngologists today. The procedure requires the young patient to undergo general anesthesia; the tonsils are completely removed with minimal post-operative bleeding. 

 

Electrocautery:

Electrocautery burns the tonsillar tissue and assists in reducing blood loss through cauterization. This method is the most commonly used technique today. Research has shown that the heat of electrocautery (400 degrees Celsius) results in thermal injury to surrounding tissue and may result in more discomfort during the postoperative period.

 

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°. The advantages of this technique are possibly less pain, faster healing, and less post operative care. However, the risk of post-operative bleeding may increase.

 

Consult with your specialist regarding the optimum procedure to remove or reduce your child’s tonsils and adenoids.

 

 

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