In the depths of the pharynx, on its lateral surfaces, there are two formations, which are called tonsils (glands). They got their name due to the resemblance to the nut of the same name. The glands belong to the glands of the body's immune system and are part of the lymphoepithelial pharyngeal ring.
Tonsil function
Even if you suffer from chronic tonsillitis, before deciding to remove tonsils, you need to figure out why they are needed in the body. The main function of the glands is to provide protection. These formations are involved in the disposal of viral and bacterial infections that enter the body by airborne droplets. After removal of the tonsils, this barrier disappears, so nothing is standing in the way of microbes. In addition, protective substances are produced in the tonsils. Tissues of these formations produce interferon, lymphocytes and gammaglobulin.
Causes of Gland Removal
But in some cases, the tonsils cease to cope with their protective functions. As a result of a deterioration in the general state of immunity, a chronic disease known as "chronic tonsillitis" can occur. Removing tonsils in this case is far from the only way to solve the problem. Although it seems to many the simplest.
The question of removal arises in cases where the palatine tonsils cannot withstand microbes that enter the body by airborne droplets. In this case, the patient suffers from recurrent tonsillitis, constant exacerbations of chronic tonsillitis. In the tonsils in these cases, an infectious-inflammatory process takes place. In the gaps accumulates and stagnates pus. These masses inflame and irritate the tissues of the tonsils. In the absence of treatment, the glands become a constant source of infection of the body, because in these weakened formations pathogenic microbes begin to multiply. In cases where conservative treatment does not give positive results, or prolonged intoxication of the whole body is observed, the doctor may advise removal of the tonsils. Patient reviews for the most part indicate that people regret that they hastened to agree to an operation. Therefore, do not rush if not all treatment methods have been tried.
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 a disease such as chronic tonsillitis. Removal of tonsils, reviews of which are rarely positive, with advanced forms of the disease is often the only way. If you do not want to bring the tonsils to this state, then it is important to know that tonsillitis that has not been completely treated lead to the chronic form of tonsillitis. Unfavorable external factors include poor ecology, air pollution, low-quality drinking water. In addition, severe stresses, a general weakening of the body's defenses, various diseases of the oral cavity or nose can lead to the development of the disease. Ordinary caries or purulent sinusitis can cause the patient to become infected with the tonsils.
Symptoms of chronic tonsillitis
Of course, a slight pain and sore throat several times a year is not a reason to speak about the need for surgical intervention. Chronic tonsillitis has slightly different symptoms. These include aching pain in the joints, muscles, region of the heart, kidneys, lower back, sensation of a foreign body in the throat, weakness, increased fatigue, a marked decrease in performance. Symptoms include subfebrile temperature, the appearance of persistent rashes on the skin and even a bad mood.
The doctor says that it is necessary to remove tonsils with chronic tonsillitis, when the disease threatens with complications. It can lead to heart disease - myocarditis, kidney damage - glomerulonephritis, joint inflammation - 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 bloodstream of the body and damage the cartilage and ligamentous tissue. Others can lead to subfebrile temperature, a change in tests, and cause headaches. If there is streptococcus belonging to group A in the tonsils, then the protective cells of the body will attack it. The protein of this bacterium is similar to that found in the connective tissue of the heart muscle. Because of this, immunity 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. Itching, rashes and even asthma may begin to develop.
Surgical intervention
Despite the fact that many doctors recommend tonsils removal for chronic tonsillitis, reviews suggest that at first it is better to try all kinds of conservative treatment methods, consult in several clinics with various ENT doctors. Of course, if they do not help, then you will have to go for surgery. In most cases, doctors recommend a bilateral tonsillectomy. This removes all the tissue of these protective formations. But sometimes it is enough to conduct partial removal of the tonsils in chronic tonsillitis. This operation is called bilateral tonsillotomy.
Only the specialist can choose the most suitable surgical option in your case, based on the anamnesis and general health condition. Do not insist on the operation yourself if the doctor advises you to try to treat chronic tonsillitis. Removal of tonsils (reviews under general anesthesia recommend this operation) is carried out only when there is an absolute indication for this. Previously, such surgical intervention was carried out only under local anesthesia, but thanks to the advent of modern anesthetics, full anesthesia is now practiced.
Tonsil Removal Methods
The main method of getting rid of palatine formations in the throat is conventional surgery. It is carried out using surgical scissors and a wire loop. This method is quite common and well-developed by surgeons; through it, tonsils are most often removed for chronic tonsillitis. The patients' reviews 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 tonsils in chronic tonsillitis by the specified method allows the patient to recover quickly. But it makes no sense when the tissue is severely affected.
In addition to conventional surgery, your doctor may recommend using an ultrasonic scalpel, electric current, radio waves, or laser. All these methods allow you to quickly remove tonsils in chronic tonsillitis. The methods developed by modern medicine can reduce the time of both the operation and the postoperative period.
Laser intervention
If you want to immediately return to normal life after the operation, during which the tonsils will be removed, 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 4 days. Another advantage of this method of getting rid of tonsils is that it is completely bloodless. The beam coagulates all damaged vessels. If you decide to remove tonsils with chronic tonsillitis with a laser, then do not feel all the “charms” of the postoperative period. After all, pain after such an intervention will be less pronounced.
But, as with conventional tonsillectomy, laser surgery must be prepared. First of all, all potential foci of infection in the nasal and oral cavity are eliminated. It is also advisable to take urine and blood for analysis, take pictures of the heart and lungs. This will help to assess the general condition of the body and understand how chronic tonsillitis affected it.
Laser removal of tonsils is performed under local anesthesia. With excessive patient excitability, he may be given the drug Atropin or Pantopon half an hour before the start of the intervention. During the procedure, the glands are irradiated several times. The duration of each exposure does not exceed 15 seconds. First of all, the tissues of the rear and front arches are exposed. Only after this does the specialist begin to work on the surrounding tissue. In this case, only local anesthesia is used, and the patient should be conscious in a sitting position.
Other methods
In addition to laser destruction, tonsillectomy for chronic tonsillitis can be performed using electric current. When using this method, diseased tissues undergo electrocoagulation. This operation does not cause pain, after it there is no bleeding. But this procedure is considered relatively dangerous, as the current can damage healthy tissues.
Tonsil removal in chronic tonsillitis in adults can also be done using bipolar radiofrequency ablation. With its use, the tissues of the glands are dissected at the molecular level. However, they are not affected by a laser, nor current, nor heat. That is why there are practically no complications after such an intervention.
Surgical operation
Despite the variety of modern methods, it is often enough to remove tonsils in chronic tonsillitis in a standard way using clamps and scissors. The operation is done through an open mouth without any external incisions. After its completion, the base of the glands is cauterized. The whole procedure lasts up to 1.5 hours. It can be performed both under local and
general anesthesia.After removal of the tonsils, the patient is laid on the right side, and his neck is covered with ice. This causes vascular contraction and prevents the occurrence of postoperative bleeding. In addition, a course of antibacterial therapy is prescribed.
On the day of surgery, the patient is allowed only a few sips of water. In the next few days, the diet includes liquid mashed food, which is used only in cold form. Such nutrition promotes the healing of wounds that have arisen after tonsillectomy has been performed.
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 intensify. After a week, the pain may begin to give in the ear. It becomes especially apparent when swallowing. But many people think that the worst condition is on the day when tonsils are removed for chronic tonsillitis. Does it hurt during the operation itself, most patients are interested. But at the same time, they forget that surgery is performed under general or local anesthesia. Unpleasant sensations appear when the effect of anesthesia recedes.
The consequences of getting rid of tonsils
A few decades ago, the glands were considered a hotbed of infection, so they were removed by many. But now experts understand that this is a barrier to infections, which prevents bacteria from penetrating further into the body. Once 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 only a barrier 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.
If we are talking about children, then doctors, as a rule, try to preserve the tonsils at least until the age of eight. Removal of tonsils in chronic tonsillitis in infants is recommended only if the condition begins to threaten the normal functioning of other organs and systems of the body.
Patient Reviews
Each patient, before agreeing to surgery, wants to know the opinion of not only specialists, but also other people who have already had tonsillectomy. Reviews depend, as a rule, on what kind of condition the patient had before the operation. Those who were tormented by chronic chronic inflammation both in the nasopharynx and in other organs often sigh with relief after removal of the tonsils. After eliminating the main focus of the spread 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 at least for several 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 tonsils with chronic tonsillitis, it is advisable to try hardware treatment. First, the doctor flushes the gaps of the glands. This process can be carried out using a special syringe or using the Tonsilor nozzle. After cleansing the surface of the tonsils, they are exposed to low-frequency ultrasound, while delivering a drug solution to the gland tissue. But the hardware treatment does not end there. Problem spots are also treated with Lugol spray, and laser therapy sessions are conducted to relieve inflammation and reduce tissue edema. Also one of the stages is the rehabilitation of microflora, which is caused by ultraviolet radiation.
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 tonsils in chronic tonsillitis. A photo of healthy and diseased glands helps many decide on surgical intervention.
It is also important to know that most often children and young people face this problem. The question of whether tonsillectomy is necessary for chronic tonsillitis after 50 years of age is rare. At this age, there should be absolute indications for the operation. It is possible if there is a risk of serious complications. In all other cases, only conservative therapy is indicated.