Why tonsillectomy is performed

Your child will wake up in the recovery area. Many kids go home the same day, though some may stay overnight. In general, kids under 3 years old and those with serious sleep problems like apnea usually stay overnight.

Depending on the type of surgery done, recovery after a tonsillectomy may take a week or more. Expect some pain and discomfort after the tonsils are removed, which can make it hard for kids to eat and drink.

Sometimes children get dehydrated from not drinking enough when they go home, and may need to come back to the hospital for fluids. Rarely, bleeding might happen during the surgery, right after it, or up to 2 weeks later.

Call the doctor right away if your child coughs up, throws up, or spits out bright red blood or blood clots. Doctors might need to do another procedure to stop the bleeding. Kids should rest at home for a few days following surgery and take it easy for a couple of weeks. They can return to school or childcare when they can eat normally, are sleeping well, and don't need pain medicine.

Offer plenty to drink, and soft foods like pudding, soup, gelatin, or mashed potatoes until your child is ready for solid foods. Kids should avoid blowing their nose for 2 weeks after surgery, as well as any rough playing or contact sports. Call the doctor right away if your child vomits blood or something that looks like coffee grounds, or has trouble breathing.

After tonsillectomy, kids can still get colds, sore throats, and throat infections. They won't get tonsillitis unless the tonsils grow back, which is uncommon. Even though the tonsils are part of the immune system, removing them doesn't affect the body's ability to fight infections. The immune system has many other ways to fight germs.

Reviewed by: Patrick C. Versalius, in , was the first one to describe the tonsils in details, including its blood irrigation and Duverney, in , made the first accurate description of the pharyngeal area 1,2. Therefore, more detailed anatomical and histological studies were done in the 19th century, mainly the ones by Wilhelm Von Waldeyer, who described lymphatic tissues in the pharyngeal area 1,2. He reported the procedure performance for dissection and removal of the structures.

Celsus applied a mixture of vinegar and milk in the surgical specimen to hemostasis and also described his difficulty doing that due to lack of proper anesthesia 1,2. Tonsillectomy, therefore, was the last way of therapy in that time. Aetius de Amida recommended ointment, oils and corrosive formulas with frog fat to treat infections. Some recommendations for removing tonsils in that time included night enuresis bed-wetting , convulsions, laryngeal stridor, hoarseness, chronic bronchitis and ashma 2.

Other techniques for removing tonsils arouse in the Middle Ages, such as the ones using cotton lines to connect the base. The lines were daily tighted and then tonsils fell 2. The removal procedure of tonsils was abandoned up to 16th century when tools were adjusted to perform tonsillectomy.

Hildanus, in , and Heister in , presented devices similar to a guillotine-cutter for uvulotomy. These instruments were modified by Physick, who, in , in the United States, created the tonsilotome, used successfully in tonsillectomies 1,2. However, even with the exaltation of Physick, it seems to be of the French surgeon Pierre Desault the priority of the use of an instrument to performe tonsilectomy accomplishment.

Desault used, in , a metallic device developed to break up bladder stones. This half-moon shape like instrument had, in its extremity, a small knife that suited perfectly to tonsils. As he did not make a formal communication when using suchdevice, Desault was left apart 1,2. Fahnestock, in the United States, , Mackenzie in London, , Brunings in and Sluder in in the United States developed similar equipment. Greenfield Sluder, an ENT doctor, in Saint Louis was not the first to use the guillotine-cutter for tonsillectomy, but he published a study, in , in which he affirmed to have reached They all aimed to accomplish surgery as fast as they could, especially in children, for the account of the lack of anesthetic techniques.

Important steps in the progress of the tonsillectomy were taken using mouth-gap and tongue-depressors, besides the positioning of patient with leaning and suspended head. This position was first described by Killian in , but only adopted after improvements on anesthesia techniques 1,2. At the beginning of 20th century, the use of forceps and scalpels resulted in less bleeding 1,2. From , tonsillectomy surgery became a common and safe procedure, when Cohen adopted ligature of bleeding vessels to control perioperative hemorrhage.

It is estimated that in the United States 1,, tonsil surgeries were performed in , around , in and , ones per year in the last decade 1,2. This resulted in thousand of surgeries. Tonsils were, then, removed and, in many cases, when there was no symptom improvement, so were teeth 1,2,5.

As time went by, due to lack of convincing results and excess of indications, this procedure lost its reputation, and as a consequence it was not recommended even for cases when there was such need. Therapeutical advance on medicine, especially with the use of antibiotics and improvement on work conditions on public health services and on group medicine also contributed for a reduction on tonsil removal surgery.

The use of all this, even so surpassed, left a stigma for the tonsillectomy, not very well accepted by some patients and even by some doctors from other areas. As result of surgery immunity acquisition against the virus of poliomyelitis can be slower and greater incidence of the disease in children not vaccinated might occur. However, it does not modify the occurrence of rheumatic fever, it can reduce outbrakes of hematuria blood in urine and proteinuria in kidney diseases and improve conditions of asthmatic bronchitis and allergic rhinitis.

At the current moment, knowing tonsil physiology and physiopathology adenoids tends to balance the correct recommendation of surgery. Although recommendations integrate a dynamic process that modifies itself according to the development of the tonsil disease knowledge and its regional and systemic repercussions, surgery, when well recommended, brings potential benefits as reduction of severe respiratory blockage; reduction on frequency, duration and gravity of ENT disease; reduction on hearing losses, besides improvement and growth of systemic diseases.

One of the most famous cases is the one of the first president of the United States, George Washington, who died in of peritonsillar abscess 4. In December , George Washington fell ill in the city of Mount Vernon, Virginia, suffering from peritonsillar abscess, presenting dyspnea. He was assisted by three doctors. Barth, MD. Larger text size Large text size Regular text size.

What Is a Tonsillectomy? Why Are Tonsillectomies Done? Teens usually have a tonsillectomy because: Their tonsils are so big they block the airway and make it hard to breathe.

Swollen tonsils can make it hard to breathe, especially during sleep. Someone might snore and stop breathing for short periods while asleep when the tonsils get in the way. This is called obstructive sleep apnea. Apnea can make someone miss out on healthy, restful sleep, and even lead to health problems. Their tonsils get infected often.

A health care provider might recommend removing the tonsils if someone gets a lot of tonsil infections called tonsillitis. Experts define "a lot" as when a doctor diagnoses the person with at least 7 infections a year, more than 5 infections a year for 2 years in a row, or three infections a year for 3 years.

What Happens Before a Tonsillectomy? What Happens During a Tonsillectomy? The two main types of tonsillectomy surgery are: Traditional tonsillectomy: Both tonsils are completely removed. Intracapsular tonsillectomy: The surgeon removes all the affected tonsil tissue, but leaves a small layer to protect the throat muscles underneath.

There's a very slight chance that the remaining tissue can re-grow or become infected and need more tonsil surgery, but this isn't common. If you have this type of surgery, you will: recover faster have less pain not need as much pain medicine have a lower risk of bleeding be better able to eat and drink after the procedure.