Tonsillectomy is a surgical operation for the complete removal of palatine tonsils: indications, contraindications, consequences

Everyone knows what a sore throat is. Acute respiratory infections and angina are observed in almost every person at least once a year. Some people suffer from throat pathologies more often. Especially it concerns those who have chronic inflammation of the ENT organs. A common disease is sore throat. It occurs both in the adult population and in children. Symptoms of this pathology are rather unpleasant. Probably everyone felt pain when swallowing food. Progression of angina leads to an increase in body temperature, general weakness. This pathology is caused by inflammation of the palatine tonsils. If the disease goes into a chronic form, the tonsils become permanently enlarged. In this case, unpleasant sensations during swallowing occur very often (up to 10 times a year). In such cases, surgery is recommended - tonsillectomy. This is a forced procedure, which is resorted to ineffectiveness of conservative treatment.

What is tonsillectomy?

Tonsillectomy is one of the methods of treating chronic inflammation of the tonsils. Normally, these formations perform the protective function of the body. Palatine tonsils belong to the lymphoid organs. They secrete special cells of the immune system, which are designed to fight microbial agents. Therefore, when bacteria and viruses enter the oral cavity, the tonsils increase. They are like a barrier to passing the infection in the respiratory tract. In their absence, microbes do not linger in the oral cavity, but almost immediately fall into the bronchi and lungs.

Therefore, surgery (tonsillectomy) is not carried out without strict need. It is only needed in cases where the function of the tonsils is broken, and they impede the breathing process. Also, surgical intervention is recommended for people who have frequent recurrences of chronic tonsillitis (tonsillitis). Surgical removal of tonsils has been used for several thousand years. The operation is not dangerous, nevertheless can lead to unpleasant consequences (the development of pneumonia on the background of respiratory infections). Therefore, before deciding on surgical intervention, it is worthwhile to learn about the advantages and disadvantages of tonsillectomy. In case of dispute, it is necessary to consult several specialists.

Indications for conduction

Tonsillectomy refers to the most common surgical interventions on ENT organs. This surgical procedure does not take much time. The risk of postoperative complications is minimal. In addition, in some clinics laser tonzlelectomy is performed. It has advantages over a routine operation. Despite this, the removal of tonsils without the presence of strict indications is not recommended. After all, these data impede the development of pathologies of the lower respiratory tract. There are the following indications for tonsillectomy:

1. Violation of the processes of breathing and swallowing. The pronounced hypertrophy of the tonsils leads to the fact that air and food can not flow freely into the mouth and nasopharynx. There are 3 degrees of increase in these organs. Absolute indications for conduction of tonsillectomy is the third stage of hypertrophy. In this case, enlarged tonsils completely cover the entrance to the pharynx. At the second degree of hypertrophy tonsillectomy is not always carried out.
2. Abscesses of ENT organs, arising against the inflammation of the tonsils. In this situation, tonsillectomy is an urgent necessity. Removal of the tonsils is necessary to provide access to the abscess and cleanse the organs from the pus.
3. Decompensated chronic tonsillitis. In this case, the tonsils disintegrate due to constant inflammation. The function of the organs is completely broken.
4. Frequent relapses of chronic tonsillitis. This refers to the exacerbation of the disease more than 7 times during the year. This case refers to the relative indications for tonsillectomy. The operation is carried out at the patient's request.
5. Combination of recurrent tonsillitis and hypertrophy of tonsils of the 2nd degree.
6. Predisposition to severe complications arising on the background of sore throat. These include diseases such as rheumatism, hemorrhagic vasculitis, glomerulonephritis. More often these pathologies develop with staphylococcal tonsillitis.

In the case of absolute indications, the refusal of surgical intervention can lead to serious complications. Therefore, before deciding whether to remove tonsils, it is necessary to find out what condition the organs are in.

Contraindications

Tonsillectomy is an operation that in some cases is not recommended by otolaryngologists. Sometimes the removal of tonsils is not only not beneficial, but also worsen the patient's condition. There are 2 groups of contraindications for conduction of tonsillectomy: absolute and temporary. In the first case, the operation is prohibited, since it represents a danger to the life of the patient. With relative contraindications, tonsillectomy can be postponed for a while. Removal of palatine tonsils is strictly prohibited in the following cases:

1. Diseases of vital organs, which are in the stage of decompensation. These include cardiac, hepatic and renal failure.
2. Pathology of the hematopoietic system. Among them, acute and chronic leukemia, severe degree of anemia, hemophilia.
3. Diabetes mellitus in the stage of decompensation.
4. Anomalies of vessels passing near the tonsils (aneurysm, abnormal pulsation of arteries and pharyngeal veins).
5. An open form of tubercular inflammation of the lungs.
6. Pathologies of the brain, in which a person is not able to adequately assess the situation.

With relative (temporary) contraindications, the patient needs first to cure acute inflammatory processes, after which tonsillectomy is possible. This is provided in the following cases:

1. Infectious pathologies (chicken pox, rubella).
2. Caries or pulpitis of teeth.
3. Acute or chronic diseases in the acute stage. Especially it concerns the inflammatory processes of the ENT organs.
4. Period of menstruation.
5. Infectious lesions of the skin.
6. Allergic reaction (dermatitis).
7. Changes in laboratory tests: leukocytosis, ketonuria.

Advantages and disadvantages of tonsillectomy

Despite the benefits of surgery, it is worth remembering that after tonsillectomy, the risk of developing bronchitis and pneumonia increases. Nevertheless, in some cases it is impossible to do without the removal of tonsils. The benefits of surgery include relieving the lumen to the pharyngeal opening, getting rid of chronic tonsillitis. The main disadvantage is the rapid entry of microbes into the lower respiratory tract with an ordinary cold. Only a doctor can decide whether or not a tonsillectomy is needed. The feedback of patients who have undergone this operation is contradictory.

Types of tonsillectomy

Currently, there are many ways to remove palatine tonsils. Nevertheless, the surgical method is most often used. In addition to it, there are procedures for the removal of tonsils, such as laser tonsillectomy, excision of tissues with an electrocoagulator and ultrasonic scalpel, radiofrequency ablation. These interventions are more expensive, but are characterized by minimal blood loss and a rapid recovery period.

Removing tonsils with a laser

Currently, many operations are performed with a laser. Not an exception and tonsillectomy. Anesthetic is local, it is sprayed on the surface of the pharynx tissues. Tonsils are fixed with special forceps and direct the laser beam. As a result, layered tissue destruction occurs. This method is especially useful for partial tonsillectomy. In this case, the organs are not removed completely, but only the upper layers that have undergone inflammation. This method is characterized by low blood loss and painlessness.

Preparation for surgical removal of tonsils

This surgical intervention does not require any special training. The patient is examined for inflammation, the laboratory data (general and biochemical blood test, OAM, coagulogram) are evaluated. You can not eat before the procedure.

How is surgical tonsillectomy performed?

Traditional (surgical) tonsillectomy is performed under general or local anesthesia. Most often, the tonsils are removed together with the capsule. This is done using a wire loop. It completely covers the organ and allows it to be separated from the surrounding tissues. After this, the state of the paratonsillar space is evaluated. If necessary, the doctor opens abscesses and puts a drainage tube.

How is the postoperative period?

After tonsillectomy, the wound surfaces remain at the points of attachment of the tonsils. To avoid infection, it is necessary to properly care for the oral cavity. This is very important, regardless of the way the tonsillectomy was performed. The postoperative period lasts 2-3 weeks. On the first day, it is not recommended to eat and swallow saliva. During sleep, the patient should lie on his side so that blood does not get into the respiratory tract. 2-3 days after the operation, the wound surface is covered with a yellowish coating, subfebrile temperature is observed, the pain is increased when swallowed. This is a normal reaction of the body. Cleaning of the surfaces from plaque occurs in about 10 days. Complete healing is observed at the end of 3 weeks after the operation. Before this time, it is worth refraining from taking cold or hot food, liquids.

Tonsillectomy: consequences of surgery

With a properly conducted tonsillectomy complications are rare. Sometimes unpleasant consequences arise due to non-compliance with recommendations assigned after surgery. The most traumatic is surgical tonsillectomy. The patient's feedback after such an operation is both positive and negative. Most of the people were satisfied with the result of the surgery, some noted a change in the voice, an increase in viral infections, bronchitis, pneumonia.

Tonsillectomy: the price of this procedure

Surgical removal of tonsils refers to the planned surgical interventions. If there is evidence, it is free. In the majority of clinics other methods of this operation are performed (laser ablation, electrocoagulation). When choosing these methods, paid tonsillectomy is performed. The price of laser removal of tonsils ranges from 10 to 20 thousand rubles, depending on the clinic and the volume of the operation.