What is Tonsillitis or Adenotonsillitis?
- At the back of your throat, two masses of tissue called tonsils act as filters, trapping germs that could otherwise enter your airways and cause infection. They also produce antibodies to fight infection. But sometimes the tonsils themselves become infected. Overwhelmed by bacteria or viruses, they swell and become inflamed, a condition known as tonsillitis.
- Tonsillitis is common, especially in children. The condition can occur occasionally or recur frequently.
Causes and Symptoms of Tonsillitis
Bacterial and viral infections can cause tonsillitis. A common cause is Streptococcus (strep) bacteria. Other common causes include:
- Influenza virus
- Epstein-Barr virus
- Parainfluenza viruses
- Herpes simplex virus
The main symptoms of tonsillitis are inflammation and swelling of the tonsils, sometimes severe enough to block the airways. Other symptoms include:
- Throat pain or tenderness
- Redness of the tonsils
- A white or yellow coating on the tonsils
- Painful blisters or ulcers on the throat
- Loss of appetite
- Ear pain
- Difficulty swallowing or breathing through the mouth
- Swollen glands in the neck or jaw area
- Fever, chills
- Bad breath
In children, symptoms may also include:
- Abdominal pain
Treatments for Tonsillitis
- Treatment for tonsillitis will depend in part on the cause.
- To determine the cause, your doctor may perform a rapid strep test or throat swab culture. Both tests involve gently swabbing the back of the throat close to the tonsils with a cotton swab.
- A lab test can detect a bacterial infection. A viral infection will not show on the test, but may be assumed if the test for bacteria is negative.
- In some cases, the physical findings are convincing enough to diagnose a probable bacterial infection. In these cases, antibiotics may be prescribed without performing a rapid strep test
- If tests reveal bacteria, treatment will consist of antibiotics to cure the infection. Antibiotics may be given as a single shot or taken 10 days by mouth. Although symptoms will likely improve within two or three days after starting the antibiotic, it's important to take all of the medication your doctor prescribes to make sure the bacteria are gone. Some people need to take a second course of antibiotics to cure the infection.
What you will do if the tonsillitis became persistent, or not response to medical treatment? Then Tonsillectomy is recommended.
- Tonsillectomy is an operation to remove the tonsiles. The tonsils are often removed along with the adenoid glands. That surgery is called adenoidectomy and is most often done in children.
- The surgery is done while the child is under general anesthesia. Your child will be asleep and pain-free.
- The surgeon will place a small tool into your child's mouth to hold it open.
- The surgeon then cuts, burns, or shaves away the tonsils. The wounds heal naturally without stitches.
After surgery, your child will stay in the recovery room until he or she is awake and can breathe easily, cough, and swallow. Most children go home several hours after this surgery.
Why this procedure is performed?
The tonsils help protect against infections. But children with large tonsils may have problems breathing at night. The tonsils may also trap excess bacteria which can lead to frequent or very painful sore throats. In either of these cases, the child's tonsils have become more harmful than protective.
You and your child's health care provider may consider a tonsillectomy if:
- Your child has infections often (7 or more times in 1 year, or 5 or more times over 2 years)
- Your child misses a lot of school
- Your child has trouble breathing and does not sleep well because the tonsils block the airway (sleep apnea)
- Your child has an abscess or a growth on the tonsils
The risks for any anesthesia are:
- Reaction to medicines
- Breathing problems
The risks for any surgery are:
- Bleeding, rare 1-3%, need to come again to the hospital for controlling
Rarely, bleeding after surgery can go unnoticed and cause very bad problems. Swallowing a lot may be a sign of bleeding from the tonsils.
Another risk includes injury to the uvula (soft palate).
Before the Procedure
Your child's provider may ask your child to have:
- Blood tests (complete blood count, electrolytes, and clotting factors)
- A physical exam and medical history
- Stop all drugs not prescriped by your doctor
During the days before the surgery
- Ten days before the surgery, your child may be asked to stop taking aspirin, ibuprofen, naproxen, warfarin and other similar drugs.
- Ask your child's provider which drugs your child should still take on the day of the surgery
On the day of the surgery
- Your child will most often be asked not to drink or eat anything for several hours before the surgery
- Give your child any drugs you have been told to give with a small sip of water
- You will be told when to arrive at the hospital
After the Procedure
- A tonsillectomy is most often done in a hospital or surgery center. Your child will go home the same day as the surgery. Children rarely need to stay overnight in the hospital for observation.
- Complete recovery takes about 1 to 2 weeks. During the first week, your child should avoid people who are sick. It will be easier for your child to become infected during this time.
What is new in Tonsillectomy?
Using new techniques to reduce the time and the pain after operation like RADIOFREQUENCY OR COBLATOR.
Adenotonsillectomy techniques include the following:
- Coblation (involves using cool electrical current to remove tonsillar tissue; may produce less postoperative pain and a faster recovery)
- Dissection (most common method; involves removing the tonsils using a scalpel)
- Electrocauterization (involves using hot electrical current to remove the tonsils; may cause damage to surrounding tissue that increases postoperative pain)
- Harmonic scalpel (involves using a scalpel that vibrates; minimizes bleeding and damage to surrounding tissue)
- Laser ablation (involves using a hand-held laser to vaporize tonsillar tissue)
- Microdebridement (involves using a rotary "shaving" device to remove tissue from enlarged tonsils)
- Radiofrequency ablation (also called somnoplasty; involves using energy transferred through probes inserted into the tonsils).
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