Tonsillectomy
Alternate Names : Palatine Tonsillectomy, Lingual Tonsillectomy
Tonsillectomy is the removal of the palatine or lingual tonsils at the back of
the throat. The tonsils, along with the adenoids, are part of the system
that captures germs entering the body and triggers an immune response to an
infection.
Who is a candidate for the procedure?
The palatine tonsils are easily seen on either side of the throat at the
level of the soft palate. Removal of
the palatine tonsils is an appropriate treatment in the following situations:
if there have been 3 to 5 bacterial infections of the tonsils within 3 to 5 years
if there have been more than 6 episodes of
tonsillitis in a year
if chronic tonsillitis, or infection
of the tonsils, does not respond to antibioticsThe lingual tonsils are areas of tonsil tissue at the back of the
tongue. They may be removed for one of several reasons, including:
recurrent or chronic tonsillitis
enlargement of the tonsils that causes
sleep apnea, a breathing disorder that occurs during sleep
enlargement of the tonsils that causes
difficulty swallowing, especially in children
diagnosed or suspected cancer
How is the procedure performed?
A tonsillectomy to remove the palatine tonsils is usually done under
general anesthesia, which means that
the person is put to sleep for the procedure. A device holds the mouth open,
and a clamp is applied to the tonsil. An incision is then made in the lining
over the tonsil. This incision can be made with scissors, knife, laser, or electrocautery, which means
applying an electric current. The incision exposes a loose tissue layer between
the tonsil and the muscles of the palate. The tonsil is then "shelled" out.
General anesthesia is also used
when the lingual tonsils are removed. The mouth is held open by an
instrument called a laryngoscope. The laryngoscope is a lighted tube through
which the lingual tonsils can be seen and removed. The lingual tonsils are at
the back of the tongue and are rather firmly attached to the muscles of the
tongue. The tonsils are separated from the muscle using either laser or electrocautery.
Because the tonsils have such a good blood supply, there is often quite a bit
of bleeding. The bleeding is usually controlled with electrocautery. Commonly,
the adenoid is also infected and is removed in a procedure known as an
adenoid removal.
Recently, the Food and Drug Administration, or FDA, approved a radiofrequency
procedure to shrink tonsils in adults, rather than removing them. This
procedure is done in a healthcare provider's office using only local anesthesia, which numbs the area
around the tonsils. The person sits and opens his or her mouth while the
healthcare provider applies bursts of radiofrequency heat with a needle-like
device or wand.
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