Name of the Procedure:

Tonsillectomy, primary or secondary; age 12 or over

Summary

Tonsillectomy is a surgical procedure to remove the tonsils, which are glands located at the back of the throat. It's commonly done to treat chronic tonsillitis or other tonsil-related issues.

Purpose

The purpose of a tonsillectomy is to alleviate problems caused by inflamed or infected tonsils, such as difficulty swallowing, breathing problems, recurrent throat infections, or obstructive sleep apnea. The goal is improved quality of life through reduced infection rates and alleviation of related symptoms.

Indications

• Recurrent episodes of tonsillitis
• Chronic tonsillitis unresponsive to other treatments
• Obstructive sleep apnea caused by enlarged tonsils
• Difficulty swallowing due to tonsil size
• Suspicion of tonsillar malignancy

Preparation

• Patients are instructed to fast (no food or drink) for at least 6-8 hours before the procedure.
• Certain medications, particularly blood thinners, may need to be adjusted or stopped.
• Preoperative evaluations, including physical examination and possibly blood tests, are conducted.

Procedure Description

1. Anesthesia: The patient is placed under general anesthesia, meaning they will be completely asleep and feel no pain during the procedure.
2. Positioning: The patient is positioned flat on their back with their mouth held open using a special instrument.
3. Tonsil Removal: The surgeon uses a scalpel, cautery, or specialized surgical instruments to carefully remove the tonsils.
4. Hemostasis: The surgeon ensures bleeding is controlled, typically using cautery or suture techniques.
5. Completion: The procedure is completed, and the patient is awakened from anesthesia and monitored.

Duration

The procedure typically takes about 30 to 45 minutes.

Setting

Tonsillectomy is usually performed in a hospital or surgical center.

Personnel

• Surgeon (typically an otolaryngologist)
• Anesthesiologist
• Surgical nurses or assistants

Risks and Complications

• Common Risks: Pain, bleeding, infection, swelling
• Rare Risks: Adverse reactions to anesthesia, dehydration, damage to surrounding tissues
• Complications: Postoperative bleeding, delayed healing, changes in voice or taste

Benefits

• Significant reduction in the frequency of throat infections
• Alleviates symptoms of obstructive sleep apnea and improves sleep quality
• Easier swallowing and breathing
• Most benefits are realized within two to three weeks post-surgery

Recovery

• Pain management with prescribed medications, ice packs, and fluids
• Soft or liquid diet for the first few days
• Rest and avoidance of strenuous activities for at least two weeks
• Follow-up appointment with the surgeon to monitor healing

Alternatives

• Antibiotic therapy for infections
• Watchful waiting for less severe symptoms
• Partial tonsillectomy (removal of only part of the tonsils)
• Pros and Cons: Non-surgical options may relieve symptoms temporarily but might not provide a long-term solution. Surgery provides a more definitive resolution but involves recovery time and risks.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel anything. Post-procedure, patients may experience a sore throat, difficulty swallowing, and mild ear pain. Pain management typically involves prescribed pain medications and comfort measures like ice packs. Patients are encouraged to stay hydrated and rest to facilitate recovery.