Everyone knows what a sore throat is. Acute respiratory infections and tonsillitis are observed in almost every person at least once a year. Some people suffer from throat abnormalities more often. This is especially true for those who have chronic inflammation of the ENT organs. A common disease is tonsillitis. It is found both among adults and in children. Symptoms of this pathology are rather unpleasant. Probably everyone felt pain when swallowing food. The progression of angina leads to an increase in body temperature, general weakness. This pathology is caused by inflammation of the palatine tonsils. If the disease becomes chronic, the glands become constantly enlarged. At the same time, discomfort during swallowing occurs very often (up to 10 times a year). In such cases, surgery is recommended - tonsillectomy. This is a forced procedure, which is resorted to with the ineffectiveness of conservative treatment.
What is tonsillectomy?
Tonsillectomy is one of the methods of treating chronic inflammation of the tonsils. Normally, these formations perform the protective function of the body. Palatine tonsils belong to the lymphoid organs. They secrete special cells of the immune system that are designed to fight microbial agents. Therefore, when bacteria and viruses enter the oral cavity, the tonsils increase. They are like a barrier to the passage of infection into the respiratory tract. In their absence, microbes do not linger in the oral cavity, but almost immediately enter the bronchi and lungs.
Therefore, surgery (tonsillectomy) is not performed without strict need. It is needed only in cases where the function of the tonsils is impaired, and they complicate the breathing process. Also, surgical intervention is recommended for people who have frequent relapses of chronic tonsillitis (tonsillitis). Surgical removal of tonsils has been used for several thousand years. The operation is not dangerous, however, it can lead to unpleasant consequences (the development of pneumonia against the background of respiratory infections). Therefore, before deciding on surgical intervention, it is worth learning about the advantages and disadvantages of tonsillectomy. In disputed cases, it is necessary to consult with several specialists.
Indications for
Tonsillectomy is one of the most common surgical interventions on ENT organs. This surgical procedure does not take much time. The risk of postoperative complications is minimal. In addition, in some clinics, laser tonsillectomy is performed. It has advantages over routine surgery. Despite this, tonsillectomy without strict indications is not recommended. After all, these formations impede the development of pathologies of the lower respiratory tract. The following indications for tonsillectomy are distinguished:
- Violation of the processes of breathing and swallowing. Severe hypertrophy of the tonsils leads to the fact that air and food cannot freely pass into the oral and nasopharynx. There are 3 degrees of increase in these organs. An absolute indication for tonsillectomy is the third stage of hypertrophy. In this case, enlarged tonsils completely block the entrance to the throat. In the second degree of hypertrophy, tonsillectomy is not always performed.
- Abscesses of ENT organs that occur against the background of tonsil inflammation. In this situation, tonsillectomy is an urgent need. Removal of tonsils is necessary to provide access to the abscess and to cleanse the organs of pus.
- Decompensated chronic tonsillitis. In this case, tonsils decay due to persistent inflammation. The function of organs is completely impaired.
- Frequent relapses of chronic tonsillitis. This refers to exacerbation of the disease more than 7 times during the year. This case refers to the relative indications for tonsillectomy. The operation is carried out at the request of the patient.
- A combination of recurrent tonsillitis and tonsil hypertrophy of the 2nd degree.
- A predisposition to severe complications arising from a sore throat. These include diseases such as rheumatism, hemorrhagic vasculitis, glomerulonephritis. Most often, these pathologies develop with staphylococcal tonsillitis.
In the case of absolute indications, the refusal of surgical intervention can lead to serious complications. Therefore, before deciding whether to remove the tonsils, it is necessary to find out in what condition the organs are.
Contraindications
A tonsillectomy is an operation that in some cases is not recommended by otolaryngologists. Sometimes removal of tonsils will not only not benefit, but will also worsen the condition of the patient. There are 2 groups of contraindications for tonsillectomy: absolute and temporary. In the first case, surgery is prohibited, as it poses a danger to the patient's life. With relative contraindications, tonsillectomy can be delayed for some time. Removal of palatine tonsils is strictly prohibited in the following cases:
- Diseases of vital organs in the stage of decompensation. These include cardiac, hepatic and renal failure.
- Pathology of the hematopoietic system. Among them, acute and chronic leukemia, severe anemia, hemophilia.
- Diabetes mellitus in the stage of decompensation.
- Anomalies of the vessels passing near the tonsils (aneurysm, pathological pulsation of the arteries and veins of the pharynx).
- An open form of tuberculous pneumonia.
- Brain pathologies in which a person is not able to adequately assess the situation.
With relative (temporary) contraindications, the patient must first cure acute inflammatory processes, after which tonsillectomy is possible. This is provided in the following cases:
- Infectious pathologies (chickenpox, rubella).
- Caries or pulpitis of the teeth.
- Acute or chronic diseases in the acute stage. This is especially true for inflammatory processes of ENT organs.
- Menstruation period.
- Infectious lesions of the skin.
- Allergic reaction (dermatitis).
- Changes in laboratory tests: leukocytosis, ketonuria.
Advantages and disadvantages of tonsillectomy
Despite the benefits of surgery, it is worth remembering that after tonsillectomy, the risk of developing bronchitis and pneumonia increases. Nevertheless, in some cases it is impossible to do without removing the tonsils. The advantages of the operation include the release of the lumen to the pharyngeal opening, getting rid of chronic tonsillitis. The main disadvantage is the rapid entry of microbes into the lower respiratory tract with an ordinary cold. Only a doctor can decide whether or not a tonsillectomy is needed. Reviews of patients who underwent this operation are contradictory.
Types of tonsillectomy
Currently, there are many ways to remove the tonsils. Nevertheless, the surgical method is most often used. In addition to him, there are such procedures for removal of the tonsils as laser tonsillectomy, excision of tissues with an electrocoagulator and an ultrasonic scalpel, radiofrequency ablation. These interventions are more expensive, but are characterized by minimal blood loss and a quick recovery period.
Laser removal of tonsils
Currently, many operations are carried out using a laser. No exception and tonsillectomy. In this case, anesthesia is local, sprayed on the surface of the pharyngeal tissue. Tonsils are fixed with special forceps and direct the laser beam. As a result, layer-by-layer tissue destruction occurs. This method is especially convenient for partial tonsillectomy. In this case, the organs are not completely removed, but only the upper layers, which underwent inflammation. This method is characterized by low blood loss and painlessness.
Preparing for surgical removal of tonsils
This surgical intervention requires virtually no special training. The patient is examined for the presence of inflammatory processes, laboratory data are assessed (general and biochemical analysis of blood, OAM, coagulogram). Do not eat before the procedure.
How is a surgical tonsillectomy performed?
Traditional (surgical) tonsillectomy is performed under general or local anesthesia. Most often, tonsils are removed with the capsule. This is done using a wire loop. It completely covers the organ and allows you to separate it from the surrounding tissues. After that, the state of the paratonsillar space is estimated. If necessary, the doctor opens the abscesses and puts a drainage tube.
How is the postoperative period?
After tonsillectomy, wound surfaces remain at the tonsil attachment sites. To avoid infection, it is necessary to properly care for the oral cavity. This is very important, regardless of how the tonsillectomy was performed. The postoperative period lasts 2-3 weeks. On the first day, it is not recommended to eat and swallow saliva. During sleep, the patient should lie on his side so that blood does not enter the respiratory tract. 2-3 days after surgery, the wound surface is covered with a yellowish coating, subfebrile temperature is observed, pain when swallowing intensifies. This is a normal reaction of the body. Cleaning of surfaces from plaque occurs in about 10 days. Complete healing is observed by the end of 3 weeks after surgery. Until this time, you should refrain from taking cold or hot food, liquids.
Tonsillectomy: consequences of surgery
With a correctly performed tonsillectomy, complications rarely occur. Sometimes unpleasant consequences arise due to non-compliance with the recommendations assigned after surgery. The greatest trauma is characterized by surgical tonsillectomy. Reviews of patients after such an operation are both positive and negative. Most of the people were satisfied with the result of the surgical intervention, some note a change in voice, an increase in viral infections, bronchitis, pneumonia.
Tonsillectomy: the price of this procedure
Surgical removal of the tonsils refers to elective surgery. If there is evidence, it is free of charge. In most clinics, other methods of this operation are performed (laser ablation, electrocoagulation). When choosing these methods, a paid tonsillectomy is performed. The price of laser removal of tonsils varies from 10 to 20 thousand rubles, depending on the clinic and the volume of surgery.