TONSIL REMOVAL ALSO CALLED TONSILLECTOMY
Definition of the Tonsils:
Tonsils are two oral masses of the lymphoid tissues found at the base of your tongue. The tonsils are collection of lymphoid tissue.
Position of your Tonsils:
It is located in your nasal and oral pharynx, lying in their bed in the side walls of the oral pharynx between the anterior and posterior pillars of your fauces.
Types of Tonsils:
Below are the types of Tonsils
- First of all is The Palatine Tonsil: it is located in the oral pharynx between the arches of the fauces -opening leading to the mass.
- Furthermore, The Pharyngeal Tonsils (adenoid) is located in the posterior wall of your nasopharynx.
- Finally The Lingual Tonsils is situated at the base of your tongue.
Size of Tonsils:
This varies in ages but larger in children.
Shape of Tonsils:
It is oval in shape.
Structure of Tonsils:
Your tonsil is covered by mucous membranes termed plica triangularis. The lower pole of each is continuous with the Lymphoid tissue situated in the base of your tongue. On the surface, small openings can be seen which are the mouth of small pits in its substance called crypts.
Blood Supply in your Tonsils:
Blood supply is from the branch of external cartoid artery.
Venous drainage of your Tonsils:
The Tonsil is drained into the tonsillar plexus that joins external jugular veins.
The tonsil is being supplied by the parasympathetic and sympathetic nerves
Functions of the Tonsils:
- Your tonsils guards the entrance of alimentary and respiratory tract against bacterial invasion.
- The masses of the lymphoid tissue form a circular defense around the nasal and oral pharynx
Tonsil removal (Tonsillectomy)
This is a surgical operation that involves removal of the tonsils. The tonsils are located in the back of the throat(two smalls glands). This tonsils houses white blood cells which helps your body to fight against infection. Atimes your tonsils gets infected in the process.
Tonsillitis is the inflammation of your tonsils that can make the tonsils swollen and give sore throat. When tonsillitis reoccurs then tonsil removal is pertinent. Symptoms of tonsillitis includes swollen glands around the neck, fever, difficulty in swallowing. Close examination in the hospital can result to observation of tonsils covered in a whitish or yellow coating and a reddish throat.
In some cases the swollen region may return to normal on its own. In some other cases antibiotics or tonsil removal is advised. Most note worthy, this surgery could be an antidote for heavy snoring during sleep and sleep apnea.
These are conditions which suggests or initiates removal of the Tonsils (Surgery)
- Chronic Tonsillitis (about 3 to 4 times yearly)
- Enlarged Tonsils ( which could result to Disphagia and Dysponea)
- Bilateral Enlargement of the Tonsils
Cases of tonsillitis and the need for the process of tonsillectomy is predominant in children and adults. Similarly people of various age can experience issues with the tonsils and require operation/surgery.
In most cases, surgery is a treatment alternative for those who often get sick with tonsillitis or strep throat. Tonsillectomy is suggestive if you have had at least seven several cases of tonsillitis or strep throat. Removal of tonsil surgery can be an antidote for other medicals problems such as
- sleep apnea
- frequent snoring during sleep
- bleeding of the tonsils
- cancer of the tonsils
- swollen tonsils which result to breathing problems
These are conditions that may not suggest or initiate the process of tonsillectomy
- Acute upper respiratory tract infections including tonsillitis. In acute tonsillitis, surgical intervention is not done rather the patient is managed medically
- Acute local infection process
- Haemophylias and other blood dysrases
- Acute pulmonary disease or vascular anomalies in the tosnilar region
- In times of epidemic
Pre-operative Need : Preparation for tonsil removal
These are the necessary things that should be checked out for before you undergo the process of tonsillectomy
- Early Admission: First of all this is to ensure that you are effectively investigated and observed and if you are accustomed with the environment
- Isolation/Investigation: Furthermore your Throat swab is taken to the lab, your blood sample will also be collected for HB, grouping and cross matching
- Nutrition need:It is also important that you feed on fluid diet which is rich in vitamins and protein
- Observation: You will be treated of all underlying infections, your Pulse rate and nasal discharge is also checked.
- Cleanliness (oral hygiene): You will need to wash or clean your mouth 1 to 2 times daily with oraldine mouth wash. Your mouth should be properly cleaned before taken to the theater to prevent the spread of infections
- Need for Rest: There is need that you have adequate rest so as to conserve energy before the surgery
- Psychotherapy: If the patient is your child, you and your child would be admitted, the likes and dislikes of the child would also be considered during this period
- Need for Relieve of Pain: Pain relief is achieved by initiating Aspirin gaggle
Consequently you have to stop taking anti-inflammatory drugs 1-2weeks before the surgery. These drugs includes naproxen, aspirin, and ibuprofen. Drugs of this sort can increase your bleeding during and after the surgery. You should get the doctor's consent on medications , herbs, or vitamins to be taken.
You should also fast after midnight before the tonsil removal. That is to say that you will rule out food or drinks due to the fact that when the stomach is empty, it reduces your risk of feeling nasuseous from the anesthesia)
Immediate Pre-operation preparation
This includes measures you have to take immediately before you undergo the surgery.
- Pre medications: You will take Atropine (0.3g),this for bronchial secretion
- Investigation: The result and chart of the medical investigation carried out on you would be taken along with you to the theater.
- You will also be checked out for vital signs
The Process of Tonsillectomy
The tonsils can be removed in diverse ways. One of the predominant methods is the 'cold knife (steel) dissection". Here, the doctor (surgeon) will remove the tonsils with a scalpel.
Another method is the 'cauterization method', this involves burning away the tissues. Using sound waves (also called Ultrasonic vibration) can also be used in some process of tonsillectomy. Tonsil removal is usually done within half an hour to one hour.
The time for the surgery is dependent on the surgical method that is being used by the surgeon. Anesthesia for surgical operation would be used. This would in turn cause you to sleep and thus hide the pain of the surgery, you would wake up in the recovery room after successful surgery. Your blood pressure, pulse and heart rate would be examined after the surgery by the medical staff. You can decide to go home the same day of successful tonsil removal.
NB: Immediate Post Operation needs
These are measures that will be taken immediately after you have been operated on.
- Making of the bed: While you are in the theatre, bed is made to receive you in the recovering room.
- Swallowing reflex will be observed
- Your mouth would be checked for secretion, If there is secretion, your head would be turned in a position that would allow the entrance of the catheter in between your teeth and the mollows
- As soon as you have taken Aspirin gaggle (Asa gaggle) you would be fed. If not done there could be possibility of you swallowing the substance during the gaggling which could possibly result to gastritis if not fed, thus your food be assembled before the Asa gaggling.
- On the second day after you successful the surgery, you will be given oral fluids. On the third day, you should take a semi solid fluid for example pap or custard.
- Position: the position in tonsil removal - you will be placed on a position lateral with your upper leg flex. One hand flex in front of your face, pillow support would be introduced for the this position.
- Observation: There is need to check for your Swallowing reflex
- Adequate rest is need after your surgery.
- When you start swallowing quite early enough there would be Reduction of throat oedema and stiffness of your neck .
- To ensure relieve of pain. You will take Pathedine 50-100mg if you are an adult because children are not sedated
- It is important that you take your Oral hygiene serious
- Nutrition: Do not take milk after the operation since it coats the sore and a form if focci for the organism
- Pain is relieved when you take fluid diet. (disprin tab or Asprin gaggle also necessary)
- The patient should be given fruit juice and copias fluid after tonsillectomy.
- Chemotherapy: You should only take drugs prescribed by the doctor . (This includes: Antibiotics, Analgesics, haematinic, vitamin).
- You would also need Psychotherapy.
This are measures that should be taken immediately after successful surgery
- You should be observed for cough and swallowing reflexes
- Your Pulse rate should be checked to note signs of haemorrhage, Vital signs should be checked until you fully recover
- You can breach bleeding by constant swallowing
- Your Vomitus is kept for close examination
- If the doctor/nurse observes stale blood, this indicates that it is only trickle of blood that you swallowed. If the blood is fresh, bleeding is suspected which could be because you are restless.
Possible Post-Operation Complications
- Chronic Nephritis
- Acute Rheumatism or Rheumatic Fever
Certainly, the process of tonsillectomy just like every other surgery has possible associated health risks. This includes: Bleeding, reaction to anesthesia, risk of infection and swelling.
It is possible that you can experience some pain as you recover. You may possibly have a sore throat after the surgery. You might also feel in pain in your neck, jaw or ears temporarily. Thus you are advised to get adequate rest most especially within the first two to three days after the surgery.
Eat Ice pops and also sip water so as to stay hydrated without hurting your throat . You should also take other foods such as Ice cream, oatmeal, pudding and other soft foods after a couple of days after the surgery. You should avoid Hard ,crunchy or spicy foods for several days after the surgery.
The Surgery is usually successful if it is managed well. You will recover without residuals after successful surgery.