Who needs to remove tonsils and why?

2024 Author: Malcolm Clapton | [email protected]. Last modified: 2023-12-17 03:44

How to understand that the operation will do you more good than harm.

What are tonsils

Glands are outgrowths of tissue in the back of the mouth that contain clumps of cells from the immune system. The correct anatomical name for the tonsils is the palatine tonsils.

Why are tonsils needed?

The tonsils are just a small part of the lymphoid tissue system scattered throughout the body. Tonsil-like masses are present in the back of the nose, on the back of the tongue, and in the small intestine.

The tonsils are involved in the fight against infections, but do not play a special role in this process. That is, after the glands are removed, the person will not get sick more often, since the rest of the immune system will continue to function normally.

Who needs to remove tonsils

Inflammation of the tonsils is called tonsillitis or tonsillitis. For unknown reasons, some people get sore throat often and severely.

Tonsillectomy - surgery to remove tonsils - reduces the frequency and severity of tonsillitis. The only problem is that this procedure is very unpleasant, risky and expensive. Therefore, tonsillectomy should be done only if the benefits outweigh the harm.

According to the current Clinical Practice Guideline: Tonsillectomy in Children, tonsils should be removed if:

1. During the last episode of angina, the person developed serious complications, such as jugular vein thrombosis, blood poisoning, paratonsillar abscess.
2. Sore throat each time proceeds with pronounced suppuration of the tonsils, severe pain in the throat and high fever. At the same time, the patient is allergic to various antibiotics, which makes it difficult for him to find a medicine.
3. If the child has PFAPA syndrome (episodes of angina are repeated very often, every 3-6 weeks, and are accompanied by a strong fever, sore throat, swollen lymph nodes in the neck and aphthous stomatitis).
4. The patient often suffers from angina (more than 7 times a year), and each episode is accompanied by at least one of these symptoms: a temperature above 38 ° C, a significant increase and soreness of the lymph nodes in the neck, pronounced suppuration of the glands, and the analysis for GABHS infection gives a positive result.
5. Some experts recommend removing tonsils if a child develops neuropsychiatric disorders due to a streptococcal infection. These are rare conditions, and it is not known for sure if surgery helps in such cases.
6. If it is difficult for a child to breathe at night due to the fact that the tonsils are greatly enlarged Permanently enlarged tonsils (tonsils) in children: answers to basic questions.
7. If a person suffers from tonsillolitis - round, foul-smelling deposits on the tonsils. Removing the tonsils may be the only long-term solution in this case.

When not to remove tonsils

Removing the tonsils can cause serious complications. On the other hand, in 20-50% of patients, angina becomes more rare and milder over time. Therefore, many experts recommend postponing tonsil removal for at least 12 months if:

1. Over the past year, the patient has had fewer than seven episodes of sore throat.
2. In the past two years, the person has had fewer than five episodes of sore throat each year.
3. Over the past three years, the patient has had fewer than three episodes of sore throat annually.

Is it possible to do without removing the tonsils

If the main problem is frequent or very severe sore throats, there are almost no alternative solutions.

Symptomatic treatment Evidence-based patient guidance on issues related to acute pain and inflammation in the throat and antibiotics allow more or less good control of rare episodes of sore throat, but are poorly suited if treatment is often necessary or if the risk of complications is high.

As you know, the treatment of Guideline for the management of acute sore throat with antibiotics only slightly accelerates the recovery from angina and does not provide complete protection against the development of purulent complications.

Statements about the benefits of various alternative methods of treatment (use of honey, propolis, gargling, etc.) for angina are completely unfounded.

How is the operation going

For the operation, you need to go to the hospital for 1-3 days. Preoperative preparation and the procedure itself take 1–1.5 hours. The actual removal of the tonsils takes about 10-15 minutes.

During the operation, the patient is under sedation. This is a type of anesthesia that eliminates pain and most of the unpleasant memories, but leaves a person awake so that he can fulfill the surgeon's requests. In children, the operation can also be performed under general anesthesia.

Many patients are allowed to go home the day after surgery.

For the patient, the most frustrating part is the recovery period. In the first 7-10 days after the operation, the sore throat is very severe. At this time, all patients need quality pain relief. Not only medicines will help in this, but also cold food, including ice cream.

Children need especially careful care. Care should be taken to ensure that the child receives adequate pain relief as recommended by the doctor. In addition, it is important that the child drinks at least 1 liter of liquid per day and at least ate a little. Therefore, give the baby everything that he loves. The quantity of food during this period is more important than its quality. Well, it is also desirable to remove tonsils in children and adults so that the food is soft, without sharp edges, cold or slightly warm.

What complications can be

Removing the tonsils is a relatively safe operation. But sometimes complications do happen. Clinical Practice Guideline: Tonsillectomy in Children.

According to one observation in England, approximately 1 in 34,000 surgeries end in the death of a patient.

Severe bleeding after surgery occurs in 1–5 out of 100 patients. Other serious complications, such as a fracture of the mandible, severe burns, or damage to the teeth, are rare.

For unknown reasons, some patients have permanent neck pain after surgery.

The risk of severe bleeding becomes negligible 24 hours after surgery.

conclusions

There are certain clinical indications for tonsil removal. In other cases, surgery can do more harm than good.

If you were advised to remove tonsils, ask why exactly and on what result you can count on.

And read Lifehacker's tips for making medical decisions and communicating with your doctor.