Almond removal
synonym
Tonsillectomy
General
In the case of more than three to four tonsillitis per year (recurrent tonsillitis or chronic tonsillitis), the indication for removal of the tonsils (Tonsillectomy).
Even if there is an abscess in the area of the tonsil (see also: Tonsillitis) as a complication of tonsillitis (peritonsillar abscess), the removal of the affected tonsil is often the treatment of choice.
Another common reason for tonsil removal in children is hyperplasia (enlargement) of the tonsils. Such an enlargement can make it difficult to breathe through the nose.
It often occurs in combination with hyperplasia of the pharynx. With such an enlargement of the palatine tonsil, the almond as a whole away but will just a part (Tonsillotomy) so that a Reduction of the palatine tonsil results. This is more beneficial in that, especially in small children, the tonsils still fulfill important defense functions within the framework of the immune system. This is also the reason why a complete removal of the tonsils (tonsillectomy) in children under four years of age is only carried out under the strictest indication.
The tonsillectomy is usually done under general anesthetic. The almonds are in a surgery of about one half an hour Duration on both sides out of their capsule peeled off.
Figure almonds
- Palatine almond (blue) -
Palatine tonsil - Pharyngeal tonsil (green) -
Pharyngeal tonsil - Tongue almond (yellow) -
Lingual tonsil - Posterior palatal arch -
Arcus palatopharyngeus - Tongue - Lingua
- Hard palate -
Palatum durum - Soft palate -
Palatum molle - Anterior palatal arch -
Arcus palatoglossus - Incisors -
Dens incisivus - Lower jaw - Mandible
- Hyoid bone - Os hyoideum
- Epiglottis - epiglottis
- Throat - Pharynx
- Nasal cavity - Cavitas nasi
S - food route
L - airway
You can find an overview of all Dr-Gumpert images at: medical illustrations
Most common complication of the operation Secondary bleeding. These can still occur several days after the operation, so children are advised before the operation stationary recorded and then for about one week inpatient supervised.
To first pain relief becomes common - especially in children Ice cream used, continue to be Painkiller helpful, but those that interfere with blood coagulation should be avoided, such as ASA (acetylsalicylic acid).
Frequently used are:
- Metamizole
- Diclofenac and
- Paracetamol
disadvantage
The Almonds take over, especially in the first six years of age an important part of the Immune defense in the human body. In doing so, they attack any substance that passes them and is found to be harmful. What is important here is that the body is one, so to speak immunological memory Has. If the substance gets past the tonsils again, this time it can be fought much more effectively and faster. It follows that removing the tonsils very early has disadvantages.
For this reason, nowadays children who have not yet turned six are only used in exceptions advised to have tonsils. Since the tonsils naturally regress from age six, removal at this point is not a problem. There are several reasons for removing the tonsils. The most common is the reason recurrent tonsillitis. Contrary to popular belief, however, despite the removal of the tonsils, they can still Inflammation in the throat arise. A Colonization by bacteria In this area it is reduced by the distance, but contrary to popular opinion, it cannot be excluded.
Pain
After the tonsils have been removed, with moderate to very severe sore throat be expected. The pain is typically the first two days worst after surgery and keep losing weight. As a pain reliever medication is mostly used Metamizole or Diclofenac prescribed. Painkillers that contain the active ingredient Acetylsalicylic acid should not be used as a medication, as this is also a anticoagulant effect included and so the risk of Rebleeding would increase significantly. The feeling of a sore nose is also relatively common because the patient must be intubated through the nose during surgery. It is important to get enough after surgery liquid to take in that one dry throat area may make the pain worse.
Certain food and drink can also lead to pain after the operation. For this reason, care should be taken no spicy, sour, very hard or hot things to take in.
When does it make sense to have tonsils removed?
A few decades ago it was assumed that the function of the almonds did not play a major role in children. That is why, especially in the 1960s, a great many children had their tonsils removed for fear of recurring Tonsillitis. Today the state of research is different. It is believed that the tonsils function as organs of the Immune defense, especially in the first six years of development, play a crucial role. For this reason, the tonsils are now usually only removed from children who have reached the age of six. A tonsil removal is useful for some disease patterns of the tonsils. These include chronic tonsillitis, recurring Tonsillitis (three to six times a year), Tumors of the tonsils, the Sleep apnea syndrome, at a sepsis or one Mediastinitiscaused by tonsillitis, that PFAPA syndrome or at pus in the throat, which can be associated with tonsillitis. A strong one Bad breathwhich is caused by the tonsils may also be a reason for removal.
What are the risks of having tonsils removed?
As a general rule, surgery always involves a certain amount of risk. However, removing the tonsils is one of the most most common operations at all, and even the most common procedure in ear, nose and throat medicine. Because of the routine of the operation it is, in spite of it general anesthetic, a relative low-risk intervention.
The most common complication of tonsil removal is one Bleeding after the operation. She joins 3-4% of the operated on, and is at 1-2% pensionable. In most cases one is sufficient Ice wrap around the neck to stop the bleeding, sometimes a second operation may be indicated. You can up to three weeks occur after surgery and in rare cases even life threatening be. Other complications are Sore throat, Difficulty swallowing, Taste disorders, and a Injury to the hypoglossal nerve. Overall, the duration of the complication complaints is significantly shorter in children than in adults. Due to the risk of rebleeding, the removal of the tonsils is not outpatient carried out, but the patients mostly stay one week inpatient in the hospital for control.
