Tonsillectomy is a surgical method for treating chronic tonsillitis, which involves complete removal of palatine tonsils.
In adults, doctors are obliged to remove the tonsils only in the case, when all tried and tested conservative methods are powerless before infection.
Indications for the surgery Tonsillectomy
• tonsillitis occurs frequently (more than two in twelve months),
• tonsillitis doesn't respond to conservative treatment: repeated courses of antibiotics, tonsil lavage and physical therapy do not achieve a stable remission of the disease,
• Streptococcus caused acute rheumatic fever or chronic rheumatic fever (there are lesions of heart valves or myocarditis, or heart failure),
• there is reactive arthritis,
• kidney failure (pyelonephritis, post-streptococcal glomerulonephritis, or chronic renal failure);
• lymphoid tissue has grown so large that it prevents normal breathing or swallowing of food, leads to snoring
• tonsillitis complicated by peritonsillar abscesses.
Methods of carrying out the surgical operation
1. Classical – surgery is performed under general anesthesia with the use of a scalpel, scissors or a loop, when the whole tonsil is completely cut out or pulled out. Electrocoagulation helps to stop bleeding. The method is radical, allowing you to get rid of the source of infection forever. Ideally, a moderate pain syndrome characterizes the healing process, recurrences of chronic tonsillitis do not take place.
2. Laser tonsillectomy. A short procedure, lasting no more than half an hour. The laser both removes tissues and sinter the vessels, preventing excessive blood loss. There are risks of burns mucous, so the healing period is prolonged. Variations of the method involve working with different types of lasers: infrared, fiberoptic (when you need to remove most of the tonsil).
3. Cold plasma technique (cobblator, co-ablation). It is performed under general intubation anesthesia. During the surgical operation, there is almost no bleeding, and the tonsils are removed carefully. Pain after surgery is less comparing to the classical version. The essence of the method is the formation of a plasma by a directed magnetic field. For this purpose, a voltage is selected, capable of heating the fabric to 45-60 degrees Celsius. The proteins break down into carbon dioxide, water and low-molecular nitrogen-containing products.
The patient's wishes are taken into account, but it is a doctor, who makes the final choice of the method of removal, as he is responsible for the course and outcome of the treatment and can fully evaluate the patient's condition and the volume of the forthcoming surgery.
If it is recommended to have this surgery, it is necessary to undergo a standard set of laboratory examinations before the hospitalization. The minimum set of tests: general blood test, blood biochemistry, glucose, simple urine test, coagulogram, blood group and Rh factor, chest X-ray, electrocardiogram. Other tests may be also necessary: consultation of a pulmonologist or cardiologist. Considering that all people are different and the health sate of all is not the same, further tests and the consultation of a pulmonologist or a cardiologist may be necessary. The surgery is performed under general anesthesia, so you need to exclude alcohol; smoking must be reduced to a minimum, do not overeat the night before surgery. It’s necessary to take comfortable clothes with you to hospital: a sport suit, a few t-shirts, panties, changes or slippers, provisions for personal hygiene, something for leisure (books, laptops), assuming that it will be 2-3 days in hospital. Valuable things are better to give to relatives or warn the medical staff about their existing on the day of the surgery.
Day of Surgery
If the surgery is scheduled for the first half of the day, you are not allowed to eat or drink on that day, as having an empty stomach is important during a surgery and anesthesia induction. If the surgery is scheduled for lunch or after lunch, you should calculate that the last meal of light food should be 6 hours before surgery, the last intake of clean water in the amount of 100 ml should be 4 hours before the surgery. In the ward, you need to change clothes and expect the time you will be called. In the case of surgery under general anesthesia, the most unpleasant thing for you will be one injection in a vein. And that's all. There will be no more discomfort and painful sensations. You will be put on the table and tied, but not in order that you do not run away, but for you not to fall off the table when you are unconscious.
Until full awakening, you will be under the control of doctors and only after that, you will be transferred to the ward. Therefore, if you were told that the procedure lasts for about an hour - one and a half, this does not mean that immediately upon termination you will be in the ward. This can take another 1-2 hours. After you arrive in the ward, you will be allowed to drink in 2-3 hours. It is worth remembering that it is strictly forbidden to eat hot food, fizzy drinks, citrus fruits, rough food.
Postoperative Care at home and recommendations
You need to adhere and follow the doctor's recommendations, since the greatest number of complications occurs at home. The necessary medication is usually prescribed individually for everyone at discharge. The most dangerous after tonsillectomy are the 2-3th and 9-11th days. During 14 days after the surgery, you must categorically exclude the physical load, overheating, bathroom, and hot food.
You Can: take a warm shower, walk, be outside, sneeze with your mouth open; it is necessary to protect the ear from water ingress; it is not recommended to use underground during 2-3 weeks.
You Cannot: take a bath, do sports during 1 month after the surgery, eat and drink hot products.