42821 Tonsillectomy and adenoidectomy; age 12 or over

Name of the Procedure:

Tonsillectomy and adenoidectomy (T&A); often referred to as surgical removal of the tonsils and adenoids.

Summary

A tonsillectomy and adenoidectomy is a surgical procedure to remove the tonsils and adenoids, which are lymphoid tissues located in the throat. This surgery is typically performed to address chronic infections, breathing difficulties, or other related medical issues.

Purpose

A T&A procedure addresses recurring tonsillitis, obstructive sleep apnea, breathing problems, and frequent ear infections. The goal is to reduce infection frequency, improve breathing, and alleviate related symptoms.

Indications

• Chronic or recurrent tonsillitis
• Obstructive sleep apnea
• Difficulty breathing due to enlarged tonsils or adenoids
• Frequent ear infections resistant to other treatments
• Chronic sore throat or swallowing difficulties

Preparation

• Follow fasting instructions (usually no food or drink after midnight before the procedure).
• Adjust medications as directed by your healthcare provider.
• Complete any required pre-operative assessments, such as blood tests or imaging studies.

Procedure Description

1. The patient is given general anesthesia to ensure they are asleep and pain-free.
2. A surgeon uses specialized instruments to remove the tonsils and adenoids through the mouth.
3. The surgical area is cauterized or sutured to minimize bleeding.
4. The procedure typically involves the use of a scalpel, surgical scissors, or electrocautery.

Duration

The procedure usually takes about 30 to 60 minutes.

Setting

Tonsillectomies and adenoidectomies are typically performed in a hospital or an outpatient surgical center.

Personnel

• Otolaryngologist (ENT surgeon)
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Common risks: bleeding, infection, swelling, pain
• Rare risks: reaction to anesthesia, injury to surrounding tissues, persistent voice changes
• Management of complications includes antibiotics for infection and medications for pain and swelling.

Benefits

• Reduction in the frequency and severity of throat infections
• Improved breathing and sleep quality
• Decreased incidence of ear infections
• Benefits usually become noticeable within a few weeks of recovery.

Recovery

• Patients typically go home the same day.
• Pain management includes prescribed painkillers and throat lozenges.
• Avoid strenuous activities for about two weeks.
• Follow a soft diet and stay hydrated.
• Post-operative check-up after 1 to 2 weeks.

Alternatives

• Antibiotic therapy for infections
• Watchful waiting for non-severe cases
• Continuous Positive Airway Pressure (CPAP) therapy for sleep apnea
• Pros of alternatives: Non-invasive, less immediate risk
• Cons: Potential for continued symptoms, less definitive solutions

Patient Experience

Patients can expect to be groggy from anesthesia immediately after the procedure. Throat pain and difficulty swallowing are common but managed with medications. Full recovery typically takes about two weeks, during which rest and specific dietary measures are essential for comfort and healing.