Re: getting your tonsils out
Reasons for tonsillectomy
Tonsillectomy may be performed when the patient:
- Experiences frequent bouts of acute tonsillitis. The number requiring tonsillectomy varies with the severity of the episodes. One case, even severe, is generally not enough for most surgeons to decide tonsillectomy is necessary.
- Has chronic tonsillitis, consisting of persistent, moderate-to-severe throat pain.
- Has multiple bouts of peritonsillar abscess.
- Has sleep apnea (stopping or obstructing breathing at night due to enlarged tonsils or adenoids)
- Difficulty eating or swallowing due to enlarged tonsils (very unusual reason for tonsillectomy)
- Produces tonsilloliths in the back of their mouth.
[edit] Common causes and demographics
Infections requiring tonsillectomy are often a result of
Streptococcus ("
strep throat"), but some may be due to other
bacteria, such as
Staphylococcus, or
viruses. However, the
etiology of the condition is largely irrelevant in determining whether tonsillectomy is required
[1].
Most tonsillectomies are performed on children, although many are also performed on teenagers and adults. The number of tonsillectomies in the United States has dropped significantly from several million in the
1970s to approximately 600,000 in the late
1990s[
citation needed]. This has been due in part to more stringent guidelines for tonsillectomy and adenoidectomy (see
tonsillitis and
adenoid). Still, debate about the usefulness of tonsillectomies continues. Not surprisingly, the
otolaryngology literature is usually pro-tonsillectomy, whereas the
pediatric literature has the opposing view[
citation needed]. Enlarged tonsils are removed more often among adults and children for sleep apnea (airway obstruction while sleeping), snoring, and upper airway obstruction. Children who have sleep apnea can do poorly in school, are tired during the day, and have some links to
ADHD [2] [3].
Tonsillectomy in adults is more painful[
citation needed] than in children, although each patient will have a different experience. Post-operative recovery can take from 10 up to 20 days, during which
narcotic analgesics are typically prescribed. Most surgeons advise eating soft foods after having your tonsils removed. Patients in the United States and Canada are usually advised not to eat "crunchy" or "rough" food (toast, biscuits, cookies & crackers) as these will scrape the back of the throat, increasing the risk of bleeding or infection after the operation, whereas patients in the United Kingdom are often encouraged to eat rough foods to keep the tonsillar beds clean. Some believe that dairy products tend to coat the throat causing an increase in possible infection and therefore discourage their use. Spicy and acidic foods are irritating, and should be avoided. Proper hydration is also very important during this time, since
dehydration can increase throat pain, leading to a
vicious cycle of poor fluid intake. At some point, most commonly 7-11 days after the surgery (but occasionally as long as two weeks (14 days) after), bleeding can occur when
scabs begin sloughing off from the surgical sites. The overall risk of bleeding is approximately 1-2% higher in adults
[4]. Approximately 3% of adult patients develop significant bleeding at this time. The bleeding might naturally stop quickly, or else mild intervention (e.g., gargling cold water) could be needed. Otherwise, a surgeon must repair the bleeding immediately by
cauterization, which presents all the risks associated with emergency surgery (most having to do with the administration of
anesthesia on a patient whose stomach is not empty). Various procedures are available to remove tonsils, each with different advantages and disadvantages. Children and teenagers sometimes exhibit a noticeable change in voice
[5] after the operation
[6].
[edit] Methods of tonsil removal
The first report of tonsillectomy was made by the Roman encyclopedist
Celsus in 30 AD. He described scraping
This was from Wikipedia