42842 Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure

Name of the Procedure:

Radical Resection of Tonsil, Tonsillar Pillars, and/or Retromolar Trigone; Without Closure

Summary

This surgical procedure involves the complete removal of the tonsils, the adjacent areas of the tonsillar pillars, and/or the retromolar trigone without any attempt to close the surgical site. It is commonly performed to treat malignant tumors or severe infections that have not responded to other treatments.

Purpose

This procedure primarily addresses severe infections, malignant tumors, or aggressive lesions in the tonsil and surrounding areas. The goal is to fully eradicate the diseased tissue to prevent the spread of infection or cancer, improve quality of life, and reduce symptoms such as pain and difficulty swallowing.

Indications

• Chronic tonsillitis that does not respond to antibiotics
• Malignant tumors in the tonsil, tonsillar pillars, or retromolar trigone
• Benign tumors with potential for malignant transformation
• Severe sleep apnea due to tonsillar hypertrophy
• Recurring peritonsillar abscesses

Preparation

• Fasting for at least 6-8 hours prior to surgery
• Stopping certain medications such as blood thinners as directed by the physician
• Pre-operative blood tests and imaging studies such as CT scans or MRIs to assess the extent of the disease
• Consultation with the anesthesiologist

Procedure Description

1. The patient is placed under general anesthesia.
2. The surgeon makes incisions around the tonsils, tonsillar pillars, and retromolar trigone.
3. Diseased tissues are carefully excised using surgical instruments such as scalpels and electrocautery devices.
4. The surgical field is cleaned and bleeding is controlled, but the site is left open without stitching it closed.

Duration

The procedure typically takes 1-2 hours, depending on the extent of the resection needed.

Setting

This procedure is usually performed in a hospital operating room equipped for head and neck surgeries.

Personnel

• Head and neck surgeon or ENT specialist
• Surgical nurse/scrub nurse
• Anesthesiologist
• Operating room technician

Risks and Complications

• Bleeding and infection at the surgical site
• Difficulty swallowing and temporary voice changes
• Pain and discomfort during recovery
• Potential damage to adjacent structures such as nerves and muscles
• Anesthetic risks including reactions to medications

Benefits

• Complete removal of diseased tissue
• Prevention of disease spread
• Symptomatic relief and potential cure of malignancy

Recovery

• Hospital stay for a few days post-surgery for monitoring
• Pain management with medication
• Instructions on diet modifications (e.g., soft foods, plenty of fluids)
• Encouraged rest and avoidance of strenuous activities
• Follow-up appointments for wound assessment and further management

Alternatives

• Partial resection or less invasive surgical options
• Radiation therapy for malignant conditions
• Chemotherapy as an adjunct for cancer treatment
• Conservative management with antibiotics for infections (in non-malignant cases)

Patient Experience

Patients will be under general anesthesia during the procedure and will not feel pain. Post-procedure, they may experience significant throat pain, difficulty swallowing, and a need for pain control measures. These symptoms typically improve gradually over a few weeks. Comfort measures include pain medications, ice packs, and maintaining hydration.