In the depths of the pharynx, on its lateral surfaces, there are two formations called tonsils (tonsils). They got their name due to the similarity with the nut of the same name. The tonsils are glands of the body's immune system and are part of the lymphoepithelial pharyngeal ring.
Functions of the tonsils
Even if you suffer from chronic tonsillitis, before deciding to remove the tonsils, you need to figure out why they are needed in the body. The main function of the tonsils is to provide protection. These formations are engaged in the utilization of viral and bacterial infections that enter the body by airborne droplets. After the removal of the tonsils, this barrier disappears, so nothing stands in the way of microbes. In addition, protective substances are produced in the palatine tonsils. The tissues of these formations produce interferon, lymphocytes and gamma globulin.
Reasons for removal of tonsils
But in some cases, the palatine tonsils cease to cope with their protective functions. As a result of the deterioration of the general state of immunitya chronic disease known as "chronic tonsillitis" may occur. Removing the tonsils in this case is far from the only way to solve the problem. Although it seems to many the easiest.
The question of removal arises in cases where the palatine tonsils cannot resist microbes that enter the body through airborne droplets. In this case, the patient suffers from recurrent tonsillitis, constant exacerbations of chronic tonsillitis. In the palatine tonsils in these cases, an infectious-inflammatory process takes place. Pus accumulates and stagnates in the lacunae. These masses inflame and irritate the tissues of the tonsils. In the absence of treatment, the tonsils become a constant source of infection of the body, because pathogenic microbes begin to multiply in these weakened formations. In cases where conservative treatment does not give positive results, or long-term intoxication of the whole body is observed, the doctor may advise to remove the tonsils. Most of the patients' reviews say that people regret that they rushed to agree to the surgical intervention. Therefore, do not rush if not all treatments have been tried yet.
Causes of chronic tonsillitis
In order not to bring the tonsils to a critical state, you need to know what exactly can contribute to the development of such a disease as chronic tonsillitis. Removal of the tonsils, reviews of which are rarely positive, with advanced forms of the disease oftenis the only way out. If you do not want to bring the tonsils to such a state, then it is important to know that tonsillitis that has not been fully cured leads to the chronic form of tonsillitis. Unfavorable external factors include poor ecology, air pollution, poor quality drinking water. In addition, severe stress, a general weakening of the body's defenses, various diseases of the mouth or nose can lead to the development of the disease. Ordinary caries or purulent sinusitis can cause the patient to become infected with the palatine tonsils.
Symptoms of chronic tonsillitis
Of course, a slight pain and sore throat several times a year is not a reason to talk about the need for surgical intervention. Chronic tonsillitis has slightly different symptoms. These include aching pain in the joints, muscles, heart, kidneys, lower back, sensation of a foreign body in the throat, weakness, fatigue, a noticeable decrease in performance. Other symptoms include low-grade fever, persistent skin rashes, and even a bad mood.
The doctor says that it is necessary to remove the tonsils in chronic tonsillitis, when the disease threatens with complications. It can lead to heart disease - myocarditis, kidney damage - glomerulonephritis, inflammation of the joints - rheumatism. This is due to the fact that microbes that multiply in weakened tissues of the tonsils produce toxins. Some of them enter the general circulation of the body and damage the cartilaginous and ligamentous tissues. Others may lead tosubfebrile temperature, changes in tests, cause headaches. If there is a group A streptococcus in the tonsils, then the body's defense cells will attack it. The protein of this bacterium is similar to that found in the connective tissue of the heart muscle. Because of this, the immune system begins to attack her. This leads to disturbances in the rhythm of prolapse of the heart valves. As a result, bacterial endocarditis or myocarditis may develop. In addition, chronic tonsillitis can lead to allergic reactions. There are itching, rashes, and even bronchial asthma may begin to develop.
Surgery
Despite the fact that many doctors recommend removing the tonsils for chronic tonsillitis, reviews indicate that it is better to try all kinds of conservative methods of treatment first, consult several clinics with various ENT doctors. Of course, if they do not help, then you have to go for an operation. In most cases, doctors recommend bilateral tonsillectomy. This removes the entire tissue of these protective formations. But sometimes it is enough to carry out a partial removal of the tonsils in chronic tonsillitis. This operation is called bilateral tonsillotomy.
Only a specialist can choose the most suitable option for your case, based on the history and general he alth. Do not insist on the operation on your own if the doctor advisestry to treat chronic tonsillitis. Removal of the tonsils (reviews under general anesthesia recommend doing this operation) is performed only when there are absolute indications for this. Previously, such a surgical intervention was carried out only under local anesthesia, but thanks to the advent of modern anesthetic drugs, full anesthesia is now practiced.
Ways to remove tonsils
The main method of getting rid of palatine formations in the throat is the usual surgical intervention. It is performed using surgical scissors and a wire loop. This method is quite common and well-established by surgeons; through it, tonsils are most often removed in chronic tonsillitis. Patients' testimonies indicate that during the operation, only a feeling of discomfort worries.
If the doctor recommends partial excision of the tonsil tissue, then a special device is used - a microdebrider. With its help, diseased areas are excised. Removal of the tonsils in chronic tonsillitis by this method allows the patient to recover quickly. But it doesn't make sense when the tissue is severely damaged.
In addition to conventional surgery, a doctor may now recommend using an ultrasonic scalpel, electric current, radio waves, or a laser. All these methods allow you to quickly remove the tonsils in chronic tonsillitis. Methods developed by modern medicine can reduce the time of both surgery and postoperativeperiod.
Laser intervention
If you want to return to normal life almost immediately after the operation, during which the removal of the tonsils will be carried out, reviews of each of the listed methods will allow you to make the right choice. For example, laser treatment lasts no more than 30 minutes, and full recovery takes place in 4 days. Another advantage of this method of getting rid of tonsils is that it is absolutely bloodless. The beam coagulates all damaged vessels. If you decide to remove the tonsils in chronic tonsillitis with a laser, then you will not feel all the "charms" of the postoperative period. After all, pain after such an intervention will be less pronounced.
But, as with a conventional tonsillectomy, you need to prepare for laser intervention. First of all, all potential foci of infection in the nasal and oral cavities are eliminated. It is also advisable to take urine and blood tests, take pictures of the heart and lungs. This will help assess the general condition of the body and understand how chronic tonsillitis has affected it.
Laser tonsil removal is performed under local anesthesia. With excessive excitability of the patient, he may be given the drug "Atropine" or "Pantopon" half an hour before the start of the intervention. During the procedure, the tonsils are irradiated several times. The duration of each exposure does not exceed 15 seconds. First of all, the tissues of the posterior and anterior arches are exposed to the impact. Only after that, the specialist begins to work on the surrounding tissue. AtThis uses only local anesthesia, and the patient must be conscious in a sitting position.
Other methods
In addition to laser destruction, the removal of tonsils in chronic tonsillitis can be performed using electric current. When using this method, diseased tissues are subjected to electrocoagulation. This operation does not cause pain, after it there is no bleeding. But this procedure is considered relatively dangerous, since the current can damage he althy tissue.
Tonsil removal for chronic tonsillitis in adults can also be performed using bipolar radiofrequency ablation. When using it, the tissues of the tonsils are dissected at the molecular level. At the same time, neither laser, nor current, nor heat act on them. That is why there are practically no complications after such an intervention.
Surgical operation
Despite the variety of modern methods, quite often the removal of the tonsils in chronic tonsillitis is carried out in a standard way using clamps and scissors. The operation is done through the open mouth without any external incisions. After its completion, the base of the tonsils is cauterized. The whole procedure lasts up to 1.5 hours. It can be performed under local or general anesthesia.
After the removal of the tonsils, the patient is placed on the right side, and his neck is covered with ice. This causes vasoconstriction and prevents postoperative bleeding. In addition, assigneda course of antibiotic therapy.
On the day of the operation, the patient is allowed only a few sips of water. In the next few days, the diet includes liquid pureed food, which is consumed only cold. Such nutrition helps to heal wounds that have arisen after the removal of the tonsils.
Reviews of many patients say that the recovery period after conventional surgery is quite difficult. Many complain of increasing pain. Immediately after the operation, they are not too pronounced, but after a few days they increase. After a week, the pain may begin to give in the ear. It becomes especially obvious when swallowing. But many people think that the worst condition is on the day when the tonsils are removed for chronic tonsillitis. Whether it hurts during the operation itself is of interest to most patients. But at the same time, they forget that surgery is performed under general or local anesthesia. Unpleasant sensations appear when the effects of anesthesia recede.
The consequences of getting rid of tonsils
Several decades ago, tonsils were considered a hotbed of infection, so they were removed by many. But now experts understand that it is a barrier to infections that prevents bacteria from penetrating further into the body. After you have removed the tonsils, the body will become less protected. Of the 6 tonsils in the body, only 4 will remain. Between them, the entire load on the body will be distributed.
Do not forget that tonsils are not onlybarrier to infections, but also an important part of the immune system. In addition, they produce substances that are involved in the process of blood formation.
When it comes to children, doctors usually try to keep the tonsils at least until the age of eight. Removal of the tonsils in chronic tonsillitis in children is recommended only when the condition begins to threaten the normal functioning of other organs and body systems.
Patient testimonials
Each patient, before agreeing to surgery, wants to know the opinion of not only specialists, but also other people who have already had their tonsils removed. Reviews depend, as a rule, on what kind of condition the patient had before the operation. Those who were tormented by constant chronic inflammation both in the nasopharynx and in other organs often breathe a sigh of relief after the removal of the tonsils. After the elimination of the main source of infection, the body begins to fight on its own.
But it is worth noting once again that such actions are justified if all methods of conservative treatment have already been tried. These include antibacterial, decongestant, antiseptic, immunostimulating therapy. If with the help of such treatment it is possible to achieve remission for at least a few months, then it is considered effective. In this case, the operation is not even discussed.
Hardware treatment
If conservative therapy does not give positive results, then before deciding to remove the tonsils in chronic tonsillitis, it is advisable to try the hardwaretreatment. First, the doctor washes the lacunae of the tonsils. This process can be carried out with a special syringe or using the Tonsilor nozzle. After cleansing the surface of the tonsils, they are exposed to low-frequency ultrasound, while applying a medicinal solution to the tissues of the tonsils. But the hardware treatment does not end there. Problem areas are also treated with Lugol spray, and laser therapy sessions are conducted to relieve inflammation and reduce tissue swelling. Also, one of the stages is the sanitation of the microflora, which is carried out with the help of ultraviolet irradiation.
If all the tried medical and hardware methods do not give the desired result, then there is nothing left but to agree to the removal of the tonsils in chronic tonsillitis. A photo of he althy and diseased tonsils helps many people decide to have surgery.
It is also important to know that children and young people most often face this problem. The question of whether it is necessary to remove the tonsils in chronic tonsillitis after 50 years is quite rare. At this age, there should be absolute indications for surgery. It is possible if there is a risk of serious complications. In all other cases, only conservative therapy is indicated.
