Tonsillitis surgery: Difference between revisions

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Latest revision as of 00:26, 30 July 2020

Tonsillitis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Chronic cases may indicate tonsillectomy (surgical removal of tonsils) as a choice for treatment.[1] Subacute tonsillitis (which can last between 3 weeks and 3 months) is caused by the bacterium Actinomyces. Chronic tonsillitis, which can last for long periods if not treated, is almost always bacterial.

Surgery

Indications for Tonsillectomy

Following are the indications for tonsillectomy:[2]

The paradise criteria for tonsillectomy is[1]

  • 3 episodes every year for more than 3 years or
  • 5 episodes every year for 2 years or
  • 7 episodes in a year

Pre-operative Medical Prophylaxis

Tonsillectomy

  • The surgery associated with the removal of the tonsils is termed a tonsillectomy.
  • Tonsillectomies are performed primarily on children that suffer from recurrent, acute bacterial tonsillitis.
  • All other cases should consider first line therapy.
  • The criteria for a child to undergo a tonsillectomy consists of seven or more documented and treated episodes in the previous year.
  • Other criteria may be met if five or more episodes occur in the two preceding years.
  • Hemorrhaging is a common, postoperative concern.
  • The least amount of hemorrhaging is associated with a cold dissection.
  • Risk of postoperative hemorrhaging can be further lessened with the proper usage of sutures and ligatures.
  • Procedures involving lasers, mono or bipolar forceps, and coblation have displayed a higher risk of postoperative hemorrhaging. [6]
  • Currently, partial removal remains the surgical option of choice.

Post Opperative Complications

The post operative complications may include:

References

  1. 1.0 1.1 Paradise JL, Bluestone CD, Bachman RZ; et al. (1984). "Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials". N. Engl. J. Med. 310 (11): 674–83. PMID 6700642. - Paradise studied 187 children with tonsillectomy or tonsillectomy and adenoidectomy. 91 children were randomly put in surgical and non-surgical groups. The other 96 were place by parent’s choice. The results favored the surgical group on reoccurrence of throat infections during their initial and second year follow-up where the data was collected. While non-surgical groups did better in the long run. 13 out of the 95 surgical group encountered surgical complications after their second year follow up
  2. Darrow DH, Siemens C (2002). "Indications for tonsillectomy and adenoidectomy". Laryngoscope. 112 (8 Pt 2 Suppl 100): 6–10. doi:10.1002/lary.5541121404. PMID 12172229.
  3. Weber RS (1997). "Wound infection in head and neck surgery: implications for perioperative antibiotic treatment". Ear Nose Throat J. 76 (11): 790–1, 795–8. PMID 9397626.
  4. Johnson JT, Kachman K, Wagner RL, Myers EN (1997). "Comparison of ampicillin/sulbactam versus clindamycin in the prevention of infection in patients undergoing head and neck surgery". Head Neck. 19 (5): 367–71. PMID 9243262.
  5. Skitarelić N, Morović M, Manestar D (2007). "Antibiotic prophylaxis in clean-contaminated head and neck oncological surgery". J Craniomaxillofac Surg. 35 (1): 15–20. doi:10.1016/j.jcms.2006.10.006. PMID 17296307.
  6. Tonsillitis and sore throat in children. United States National Library of Medicine. National Institutes of Health. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273168/

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