Everyone knows what a sore throat is. Acute respiratory infections and tonsillitis are observed in almost every person at least once a year. Some people suffer from throat pathologies more often. This is especially true for those who have chronic inflammation of the ENT organs. Angina is considered a common disease. It occurs in both adults and children. The symptoms of this pathology are quite unpleasant. Probably, everyone felt pain when swallowing food. The 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 becomes chronic, the tonsils become permanently enlarged. At the same time, discomfort during swallowing occurs very often (up to 10 times a year). In such cases, surgical intervention - tonsillectomy is recommended. This is a forced procedure, which is resorted to when conservative treatment is ineffective.
What istonsillectomy?
Tonsillectomy is one of the treatments for chronic inflammation of the tonsils. Normally, these formations perform a protective function of the body. The palatine tonsils are lymphoid organs. They secrete special cells of the immune system that are designed to fight microbial agents. Therefore, when bacteria and viruses enter the oral cavity, the tonsils increase. They are like a barrier to the passage of infection into the respiratory tract. In their absence, microbes do not linger in the oral cavity, but almost immediately enter the bronchi and lungs.
Therefore, the operation (tonsillectomy) is not performed without a strict need. It is needed only in cases where the function of the tonsils is impaired, and they impede the breathing process. Also, surgery is recommended for people who have frequent recurrences of chronic tonsillitis (tonsillitis). Surgical removal of the tonsils has been practiced for thousands of years. The operation is not dangerous, however, it can lead to unpleasant consequences (development of pneumonia against the background of respiratory infections). Therefore, before deciding on a surgical intervention, it is worth learning about the advantages and disadvantages of tonsillectomy. In cases of dispute, several experts should be consulted.
Indications for conduction
Tonsillectomy is one of the most common surgical interventions on the ENT organs. This surgical procedure does not take long. The risk of postoperative complications is minimal. In addition, laser tonsillectomy is performed in some clinics. It has advantages over routine operation. Despite this, the removal of the tonsils without a strict indication is not recommended. After all, these formations prevent the development of pathologies of the lower respiratory tract. There are the following indications for tonsillectomy:
- Violation of breathing and swallowing processes. Severe hypertrophy of the tonsils leads to the fact that air and food cannot pass freely into the oropharynx and nasopharynx. There are 3 degrees of enlargement of these organs. The absolute indication for tonsillectomy is the third stage of hypertrophy. In this case, enlarged tonsils completely close the entrance to the pharynx. With the second degree of hypertrophy, tonsillectomy is not always performed.
- Abscesses of ENT organs that occur against the background of inflammation of the tonsils. In this situation, tonsillectomy is an urgent need. The removal of the tonsils is necessary to provide access to the abscess and cleanse the organs of pus.
- Decompensated chronic tonsillitis. In this case, there is a disintegration of the tonsils due to constant inflammation. Organ function is completely impaired.
- Frequent relapses of chronic tonsillitis. This refers to exacerbations 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 request of the patient.
- Combination of recurrent tonsillitis and grade 2 tonsil hypertrophy.
- Predisposition to severe complications arising from angina. These include diseases such asrheumatism, hemorrhagic vasculitis, glomerulonephritis. Most often, these pathologies develop with staphylococcal tonsillitis.
In the case of absolute indications, refusal of surgery can lead to serious complications. Therefore, before deciding whether to remove the tonsils, you need 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 the tonsils will not only not be beneficial, but will also worsen the patient's condition. There are 2 groups of contraindications to tonsillectomy: absolute and temporary. In the first case, the operation is prohibited, as it poses a danger to the patient's life. With relative contraindications, tonsillectomy can be postponed for some time. Removal of the palatine tonsils is strictly prohibited in the following cases:
- Diseases of vital organs in the stage of decompensation. These include heart, liver and kidney failure.
- Pathologies of the hematopoietic system. Among them are acute and chronic leukemia, severe anemia, hemophilia.
- Diabetes mellitus in the stage of decompensation.
- Anomalous vessels passing near the tonsils (aneurysm, pathological pulsation of the arteries and veins of the pharynx).
- Open form of tuberculous pneumonia.
- Pathologies of the brain, in which a person is not able to adequately assess the situation.
Whenrelative (temporary) contraindications, the patient must first cure acute inflammatory processes, after which tonsillectomy is possible. This is provided in the following cases:
- Infectious pathologies (chickenpox, rubella).
- Caries or pulpitis of teeth.
- Acute or chronic diseases in the acute stage. This is especially true of inflammatory processes in the ENT organs.
- Period of menstruation.
- Infectious lesions of the skin.
- Allergic reaction (dermatitis).
- Changes in laboratory tests: leukocytosis, ketonuria.
Advantages and disadvantages of tonsillectomy
Despite the benefits of surgery, it is worth remembering that after a tonsillectomy, the risk of developing bronchitis and pneumonia increases. However, in some cases it is impossible to do without the removal of the tonsils. The advantages of the operation include the release of 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 a tonsillectomy is needed or not. Reviews of patients who underwent this operation are contradictory.
Varieties of tonsillectomy
Currently, there are many ways to remove palatine tonsils. However, the most commonly used method is surgery. In addition to it, there are such procedures for the removal of tonsils as laser tonsillectomy, excision of tissues with an electrocoagulator andultrasonic scalpel, radiofrequency ablation. These interventions are more expensive, but are characterized by minimal blood loss and a quick recovery period.
Tonsil removal with laser
Currently, many operations are performed using a laser. No exception and tonsillectomy. In this case, anesthesia is local, sprayed over the surface of the tissues of the pharynx. The tonsils are fixed with special forceps and a laser beam is directed. As a result, layer-by-layer tissue destruction occurs. This method is particularly useful for partial tonsillectomy. In this case, the organs are not completely removed, but only the upper layers that have undergone inflammation. This method is characterized by low blood loss and painlessness.
Preparation for surgical removal of the tonsils
This surgical intervention requires little or no special preparation. The patient is examined for the presence of inflammatory processes, laboratory data are evaluated (general and biochemical blood tests, OAM, coagulogram). Do not eat before the procedure.
How is a surgical tonsillectomy performed?
Traditional (surgical) tonsillectomy is performed under general or local anesthesia. Most often, the tonsils are removed along with the capsule. This is done with a wire loop. It completely covers the organ and allows you to separate it from the surrounding tissues. After that, the state of the paratonsillar space is assessed. If necessary, the doctor opens abscesses andputs a drain tube.
How is the postoperative period?
After a tonsillectomy, wound surfaces remain at the sites of attachment of the tonsils. Proper oral care is essential to avoid infection. This is very important, regardless of how 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 enter the respiratory tract. In 2-3 days after the operation, the wound surface is covered with a yellowish coating, subfebrile temperature is observed, pain when swallowing intensifies. This is a normal reaction of the body. Cleaning of surfaces from plaque occurs after about 10 days. Complete healing is observed by the end of 3 weeks after surgery. Until this time, you should refrain from taking cold or hot food, liquids.
Tonsillectomy: consequences of the operation
With a properly performed tonsillectomy, complications rarely occur. Sometimes unpleasant consequences arise due to non-compliance with the recommendations prescribed after surgery. Surgical tonsillectomy is the most traumatic. Patient reviews after such an operation are both positive and negative. Most people were satisfied with the result of the surgical intervention, some note a change in voice, an increase in viral infections, bronchitis, and pneumonia.
Tonsillectomy: price of this procedure
Surgical removal of the tonsils refers to planned surgical interventions. If there is evidence, it is free of charge. In most clinics, other methods of this operation are performed (laser ablation, electrocoagulation). When choosing these methods, a 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.
