Tonsils are like spongy lymphoid structures located in the back of the throat, serving as guardians against invading bacteria and viruses entering our body through the mouth. When these little defenders become inflamed, it’s known as tonsillitis. To deal with this issue, an Ear, Nose, and Throat (ENT) specialist can perform a surgical procedure called a tonsillectomy, where they remove these tonsils. Typically, this surgery is recommended for individuals who repeatedly suffer from tonsil infections or have large tonsils that frequently lead to infections. Tonsillectomies are quite common and straightforward procedures carried out by ENT doctors many times each year. Nonetheless, it’s worth emphasizing that the execution of this procedure can differ significantly. Within the contents of this article, you will encounter an extensive wealth of insights regarding types of tonsillectomies. This encompasses a broad spectrum, including the surgical methodologies, various approaches to the surgery, the underlying motivations for undergoing this operation, and a meticulous breakdown of the surgical intricacies.
What Is a Tonsillectomy?
Situated on both sides at the rear of the throat, the tonsils play a pivotal role in bolstering the body’s defenses against respiratory infections and diseases. Primarily, tonsils exhibit heightened activity during the formative years of childhood, as the immature immune system in children renders them particularly vulnerable to infections. Recurrent and severe tonsil infections can cause difficulty swallowing, sore throat, and fever. Under these circumstances, an Ear, Nose, and Throat (ENT) specialist might propose a type of tonsillectomy.
Tonsillectomy, which is among the frequently conducted procedures during childhood and adolescence, involves the surgical extraction of tonsils. Within adults and older demographics, types of tonsillectomy are predominantly carried out due to concerns like sleep apnea, snoring, or issues linked to tumors.
Why Are Tonsillectomies Done?
Tonsil surgeries are often performed due to infection-related reasons. Frequent tonsillitis can lead to swollen tonsils, a sore throat, and can also cause fever and difficulty swallowing. Enlarged tonsils may also necessitate a tonsillectomy. Large tonsils can obstruct the airway and make it difficult to breathe during sleep. Individuals grappling with markedly enlarged tonsils may encounter snoring and obstructive sleep apnea, a condition characterized by brief interruptions in breathing during slumber. Sleep apnea not only disrupts an individual’s ability to enjoy a restful and healthy sleep but also precipitates a cascade of additional health concerns.
The principal objective of a tonsillectomy is to enhance the quality of life for those plagued by recurrent infections, curbing work absenteeism, diminishing the reliance on medications, and averting or mitigating complications such as heart valve disease and rheumatic fever, which can arise as sequels to infections.
What Happens Before a Tonsillectomy?
Ahead of the surgical procedure, the physician will furnish the patient or their child with comprehensive guidance on the prerequisites for a types of tonsillectomy. In some cases, the physician may recommend altering or halting the use of certain medications several days before the procedure. Additionally, maintaining an empty stomach is crucial on the day of the surgery, so individuals must refrain from eating anything after midnight on the night before the operation.
Preoperative tests or blood samples may also be necessary. If the tonsillectomy is performed to address conditions like obstructive sleep apnea, other airway obstructions, or other specific medical issues, the doctor may request a polysomnography to be conducted as well.
What Happens During a Tonsillectomy?
Ear, Nose, and Throat (ENT) surgeons perform types of tonsillectomy with the patient comfortably under general anesthesia, guaranteeing a painless procedure. The surgical intervention is conducted through the mouth, without leaving any visible scars or skin incisions. During the surgery, certain instruments are placed inside the mouth to make the tonsils fully visible. Tonsil tissue is then removed either using a classic scalpel or with the assistance of specialized technological devices like thermal welding.
Post-surgery, individuals are transferred to recovery quarters, where diligent tracking of their blood pressure and heart rate takes place. Following a prosperous tonsillectomy, patients are generally released on the very day of the operation. A comprehensive recuperation usually spans a period of approximately 2 to 3 weeks.
Types of Tonsillectomy
There are five different types of tonsillectomy:
1. Bipolar radiofrequency ablation
In bipolar radiofrequency ablation, energy is transferred to the tonsils. This method, utilized in both extracapsular and intracapsular tonsillectomies, minimizes tissue damage significantly.
In these variants of types of tonsillectomy, a conductive saline solution transforms into ionized plasma, effectively disrupting the molecular bonds within the tissue, enabling its separation from the adjacent tissue. This technique not only reduces the size of enlarged tonsils but also offers the option of complete tonsil removal. Moreover, postoperative pain is alleviated, and the recovery period is notably expedited with this approach.
2. Microdebrider tonsillectomy
A microdebrider is a device that shaves the tissue using a rotating device. In such types of tonsillectomy variations, the complete removal of tonsils is bypassed, and instead, only a partial segment is extracted. A thin layer of tonsil tissue is left over the throat muscles. An Ear, Nose, and Throat (ENT) specialist can conduct this technique using local anesthesia. It boasts a brief recovery period and entails minimal post-operative discomfort, enabling the patient to swiftly resume their regular activities.
Nonetheless, it may not be the most suitable choice for individuals grappling with frequent tonsil infections. It is more suitable for people with enlarged tonsils that prevent proper breathing.
3. Electrocautery tonsil removal
In this method, which removes the tonsils by burning, the tonsil is removed at the same time and the area is cauterized to stop bleeding. In this method, which is extremely safe, effective, and quite common, there is no layer left behind after the procedure, there is no incision on the skin.
Since there is a risk of damage to the tissue around the tonsil, the postoperative recovery period may be a little uncomfortable.
4. Ultrasonic dissection
Ultrasonic dissection is a surgical approach that uses the high-frequency vibrating blade of a special scalpel to cut and simultaneously coagulate the tonsil tissue. This high frequency vibration (55,000 cycles per second) provides an extremely precise cut during tonsillectomy. Many ENT doctors prefer these types of tonsillectomy because of its precise cutting and minimal bleeding. The surgery is performed while the patient is under general anesthesia and requires the ability to control the power and vibration generated by the scalpel.
5. Cold scalpel surgery
Within these traditional and time-honored tonsillectomy techniques, the complete eradication of tonsils is achieved with a scalpel. This approach necessitates the administration of general anesthesia, and the incidence of postoperative bleeding is notably rare. The term “cold” in the name of the method has nothing to do with cryo, it is only a reference to the metal of the scalpel.
