Some patients decide to have their tonsils removed. In what cases is surgery indicated, how is it performed and what consequences can be expected from it?

When should you have your tonsils removed?

Frequent exacerbations of chronic tonsillitis are an indication for tonsillectomy.

It is resorted to only when the function is restored immune organ no longer seems possible. The main indications for the operation are:

• Frequent exacerbations of chronic streptococcal tonsillitis. The fact that the causative agent of the patient’s disease is streptococcus should be confirmed by a blood test for the titer of antistreptolysin O. Its increase reliably indicates the body’s reaction to streptococcus. If taking antibiotics does not lead to a decrease in titer, then it is better to remove the tonsils, otherwise there is a high risk of complications.
• Increase in the size of the tonsils. Sprawl lymphoid tissue may cause discomfort when swallowing or sleep apnea syndrome (holding your breath while sleeping).
• Damage to the tissues of the heart, joints and kidneys due to intoxication of the body. To establish a connection between inflammation of the tonsils and organ dysfunction, the patient is asked to perform so-called rheumatoid tests - tests for C-reactive protein, sialic acids and rheumatoid factor.
• Peritonsillar abscess. This is a condition in which inflammation spreads from the tonsils to the surrounding area. soft fabrics. Usually pathology is “silenced” medications and only then begin the operation.
• Ineffectiveness of conservative methods of therapy (including taking medications, vacuum removal of tonsil plugs and physiotherapy).

How to prepare for a tonsillectomy

Preparation for tonsillectomy is carried out in outpatient setting. The patient needs to undergo a number of tests:

• general blood test,
• analysis to determine the number of platelets,
• coagulogram (blood test for clotting),
• general urinalysis.

You will need to be examined by a dentist, cardiologist and therapist. If a pathology is identified, consultation with an appropriate specialist is indicated.

To reduce the risk of bleeding 2 weeks before surgery, the patient is prescribed medicines, increasing blood clotting. They ask you to stop taking aspirin and ibuprofen for 3-4 weeks.

Day of surgery

The doctor decides how exactly the operation will take place. Typically, the entire tonsils are removed. Partial tonsillectomy can be performed in cases of severe hypertrophy of lymphoid tissue.

6 hours before the procedure, the patient is asked to stop eating, drinking dairy products and juices. You can’t even drink water for 4 hours.

Tonsil removal in adults is usually performed under local anesthesia. Half an hour before surgery, the patient is given an intramuscular injection with sedative, then an anesthetic, lidocaine, is injected into the tissue around the tonsil.

In the operating room, the patient is seated in a chair. Inflamed organs are removed through the mouth. No incisions are made on the neck or chin.

Tonsillectomy options:

• Traditional operation. Tonsils are removed using traditional surgical instruments - scissors, scalpel and snare.

Pros: The method is time-tested and well-proven.

Cons: long period of rehabilitation.

• Infrared laser surgery. Lymphoid tissue is excised with a laser.

Pros: practically complete absence swelling and pain after the procedure, ease of performance, the operation can be performed even on an outpatient basis.

Cons: There is a risk of burns to healthy tissue surrounding the tonsil.

• Using an ultrasonic scalpel. Ultrasound heats the tissue to 80 degrees and cuts off the tonsils along with the capsule.

Pros: minimal damage to adjacent tissues, rapid healing.

Cons: There is a risk of bleeding after surgery.

• Bipolar radiofrequency ablation (collaboration). The tonsils are cut off with a cold radio knife, without heating the tissue. The technology allows you to remove the entire tonsil or just part of it.

Pros: no pain after surgery, short rehabilitation period, low frequency complications.

Cons: performed only under general anesthesia.

The entire operation takes no more than 30 minutes. After its completion, the patient is taken to the ward, where he is placed on his right side. An ice pack is applied to the neck. You are asked to spit saliva into a special container or onto a diaper. During the day (and during collocation - no more than 5 hours), the patient is not allowed to eat, drink or gargle. At extreme thirst You can take a few sips of cool water.

Frequent complaints after surgery are sore throat, nausea, dizziness. Sometimes bleeding may occur.

Depending on the method of tonsillectomy, the patient is discharged home on days 2–10. Sore throat persists for 10–14 days. On the 5th–7th day it sharply intensifies, which is associated with the removal of crusts from the walls of the pharynx. Then gradually the pain disappears.

To relieve the patient's suffering, they do intramuscular injections analgesics. Antibiotics are indicated for several days after surgery.

Home care

For 10-14 days after surgery, the patient is advised to talk less.

A white or yellowish coating appears on the operated surface, which completely disappears after tightening surgical wounds. It is prohibited to gargle and disinfect the throat while plaque remains.

Within two weeks after surgery, the patient is recommended to:

• talk less
• do not lift heavy objects,
• eat only soft, cool foods (vegetables and meat purees, soups, yoghurts, cereals),
• drink more fluids
• do not visit the bathhouse, solarium, do not fly by plane,
• brush your teeth and rinse your mouth with caution,
• take only cool showers,
• drink painkillers (paracetomol-based drugs). It is forbidden to take ibuprofen or aspirin, as they increase the risk of bleeding.

The sense of taste may be impaired for several days after the procedure.

The recovery period after tonsil removal takes about 2-3 weeks. By the end of the third week, the wounds are completely healed. In place of the tonsils, scar tissue forms, covered with a mucous membrane. The patient is allowed to return to his normal lifestyle.

Possible complications

TO negative consequences Tonsil removal in adults includes:

• Risk of bleeding within 14 days after surgery. If drops of blood appear in the saliva, the patient is advised to lie on his side and apply an ice pack to his neck. If the bleeding is intense, you need to call an ambulance.
• Very in rare cases(no more than 0.1%) it is possible to change the timbre of the voice.

Tonsil removal: pros and cons

Many patients have an ambiguous attitude towards the appointment of tonsillectomy. It's confusing to talk about tonsils– important organ immune system, the removal of which entails the development of infections respiratory tract And . Fearing complications, some patients refuse to undergo surgery.

However, doctors are in a hurry to reassure them: a tonsillectomy cannot affect the immune defense of an adult. The point is that already in adolescence The tonsils cease to be the only filter against the penetration of bacteria and viruses. The sublingual and pharyngeal tonsils come to their aid. After surgery, these lymphoid formations are activated and take over all the functions of the removed organs.

But the preservation of tonsils in the presence of indications for their elimination threatens the development of serious health problems. Inflamed tissues lose their protective properties and turn into a breeding ground for infection. In such a situation, refusing to remove them means dooming yourself to much more dangerous pathologies, including diseases of the heart, kidneys and joints. In women, the onset of chronic tonsillitis can negatively affect reproductive function.

The risks of the operation are assessed in each specific case individually. Obstacles to its implementation may include:

• vascular diseases that are accompanied by frequent bleeding and cannot be cured (hemophilia, Osler's disease),
• severe diabetes mellitus,
• stage III hypertension.

Such patients may be indicated for an intermediate procedure – laser lacunotomy. Micro-incisions are made on the tonsils using an infrared ray, through which the purulent contents flow out.

Temporary contraindications to tonsillectomy are:

• menstruation period,
• untreated caries,
• inflammation of the gums,
• acute infectious diseases,
• last trimester of pregnancy,
• exacerbation of tonsillitis,
• exacerbation of any other chronic disease.

Decreased immunity often leads to diseases such as tonsillitis, which in turn creates the ground for the formation and development of chronic tonsillitis. When such a diagnosis is made, many patients believe that it is necessary to remove the tonsils as soon as possible.

Chronic tonsillitis refers to diseases of an infectious-allergic nature with the presence of prolonged inflammation of the tissues of the tonsils, which are located in the oropharynx. In structure, they are represented by soft, porous lymphoid tissue with tubules. When asked whether it is worth removing tonsils for chronic tonsillitis, experts say that there are no extra organs in the human body, and therefore all indications should be carefully weighed and the issue should be approached carefully.

The occurrence of acute tonsillitis in a child contributes to the development of stable immunity in the body. And its decrease occurs due to frequent sore throats caused by pathogenic bacteria.

Tonsillitis comes from acute form to chronic due to improper use of antibiotics and fever-reducing drugs. Chronic inflammation may be accompanied by difficulty breathing through the nose and infections in neighboring organs.

Chronic tonsillitis in a child

In chronic tonsillitis, the soft lymphoid tissue of the tonsils replaces connective tissue with scars, which subsequently narrows and closes the tubules with the formation of purulent plugs. Various components, such as microbes, food particles, etc., accumulate in the formed places.

For the life of microbes, chronic disease creates ideal conditions, in this case, there is a decrease in the protective functions for which the tonsils are responsible. They turn into a supplier of infections and intoxication to the body, gradually increasing in size. As a result, complications and immune system disorders occur. The body affected by infections triggers the mechanism of allergic reactions, aggravating the patient’s condition.

Types of disease

IN modern medicine According to the classification, several types of chronic tonsillitis are distinguished, such as: compensated, subcompensated, decompensated. In the first case, the almond tissues become inflamed, and the tonsils perform protective functions and the body is able to cope with infections. The second type of tonsillitis is characterized by a combination local forms with recurrent tonsillitis without signs of complications. The third type of pathology is characterized by the manifestation of local symptoms and the presence of various diseases.

Complications of chronic tonsillitis include the appearance of rheumatism, kidney disease, cardiovascular system chronic forms. To avoid various kinds of complications and serious illnesses, you should undergo systematic treatment. The decompensated appearance, if multiple courses of treatment are ineffective, is eliminated surgery . Typically, the disease occurs in patients childhood, since children are susceptible colds more often.

Enlarged tonsils make breathing difficult, increase the temperature, and adults also experience snoring during sleep

An adult suffers from the disease less often and with improper treatment Complications may already develop based on existing diseases. Enlarged tonsils make breathing difficult, cause an increase in temperature, make eating and swallowing more difficult, and adults also experience snoring during sleep.

Need for removal

So is it necessary to remove tonsils for chronic tonsillitis at the present time, if pharmaceuticals are ready to offer alternative options treatment is a question that often worries patients during consultation. In the recent past, tonsils were removed to almost all people suffering from chronic tonsillitis especially with enlarged tonsils 2-3 degrees. Tonsils, according to many experts, perform certain functions for up to 5 years, and then their action ceases and therefore can be removed without problems. Previously, operations were carried out from the age of 3, but currently they are performed when a person reaches 5 years of age.

Doctors today do not treat the diagnosis categorically with mandatory surgery. Initially, conservative treatment options are used, thanks to a wide range of medications. Many of the drugs offered can shrink tonsils. If treatment is carried out in combination with physiotherapy procedures, positive results can be achieved in a short time.

Laser tonsil removal

The tonsils are removed only in certain cases, such as:

• a sore throat affects the patient at least 4 times a year;
• the occurrence of pathological processes such as damage to internal organs based on a chronic disease;
• development of an abscess after a sore throat;
• lack of positive effect after treatment with medications and physiotherapy.

The decision to remove tonsils is made by an ENT doctor, taking into account the clinical picture of inflammation in the throat, as well as the body’s immune forces.

Methods of performing the operation

Removal of the tonsils is carried out partially or completely in two ways: tonsillotomy or tonsillectomy. In addition to the standard operation, devices are used for less trauma and a quick recovery period. In several ways, partial removal is performed in order to preserve basic functions, make breathing easier, or if complete removal is not possible:

• usage liquid nitrogen;
• the use of a laser with a cauterizing effect.

The tonsils are treated with local anesthetics, and after they die under the influence of hardware mechanisms, they are removed. The techniques are painless and lack bleeding, but pain after surgery and fever for a short time are possible.

Also, after performing an operation using these methods, it is necessary to take a course conservative therapy to prevent the possibility of subsequent enlargement of the tonsils.

Complete removal or tonsillectomy is also performed in several ways that are most suitable for patients:

• surgery;
• laser destruction;
• electrocoagulation.

Surgical method for removing tonsils

The surgical method is traditionally performed using a wire loop and scissors under general anesthesia. The disadvantages of the procedure include the duration of the recovery period, possible bleeding and the appearance of serious complications associated with danger to life. During surgery, the lymphoid tissue should be completely removed to prevent subsequent growths.

The operation should only be entrusted to an experienced, trusted surgeon. Both partial and complete removal of the tonsils uses a carbon laser or infrared laser. The gentle procedure is performed on an outpatient basis, painlessly, without blood and fast healing wound Possible burns of healthy tissue near the affected area with painful sensations after the procedure.

There are certain contraindications for complete removal of tonsils:

• infectious diseases in the acute stage;
• poor blood clotting;
• diabetes mellitus;
• heart disease, such as tachycardia, severe hypertension, angina pectoris;
• pregnancy period from 6 to 9 months;
• tuberculosis disease.

Advantages and disadvantages of the operation

For patients who are often bothered by throat diseases, the question is whether it is worth removing tonsils for chronic tonsillitis . Surgical intervention on the tonsils is characterized by both certain advantages and disadvantages.

The attending physician must make a balanced, calculated decision.

The advantages of the effect of the operation include such factors as:

But it should be taken into account that the consequences after the operation of removing the tonsils have a negative effect:

• the occurrence of bleeding during surgery;
• incomplete removal of the tonsils; there is a possibility of re-growth of lymphatic tissue;
• Frequent sore throats are replaced by bronchitis and pharyngitis.

To remove tonsils or not for chronic tonsillitis is a serious decision that is made in consultation with a specialist, based on general condition body. When determining the need for surgery, a comprehensive examination is carried out, including tests, a cardiogram and referral for consultation to other specialists.

After surgery or conservative treatment, it is important to take measures to strengthen the immune system. In addition to taking vitamin complexes and medications prescribed by a specialist, you should adhere to simple rules how to regularly take care of strengthening the immune system, refuse bad habits, such as smoking, alcohol, carrying out hardening procedures, establishing complete diet nutrition, exercise.

I am tormented by endless sore throats... My throat constantly hurts and it hurts to swallow. And the tonsils, or rather their inflammation, are to blame. What to do, can remove tonsils and get rid of constant temperature and endless sick days? Should I delete or not? It’s so simple, but then you won’t have sore throats or sore throat problems. Is this so?

What are tonsils and why are they needed?

Tonsils are connective lymphoid tissue, which is entirely permeated with lymphocytes and cells, which are the main and important part of the body’s immune system (macrophages). There are six tonsils in our body: pharyngeal, palatine, lingual and tubal.

The palatine tonsils also have a hematopoietic function; in the accumulations of lymphoid tissue, lymphocytes (white blood cells) are formed, which are main basis immunity. The most important part of our immune system is the tonsils, the removal of which is not entirely in a good way affects the body as a whole.

Experts say that tonsils (or adenoids) are so important to the body that even a half-dead and collapsed tonsil produces more immunoglobulin than the rest of the immune system.

Due to the porous structure of the tonsils, all pathogenic microbes, when trying to enter the body, are surrounded by cells of the immune system and destroyed. Adenoids are a serious barrier to infections, and if the body itself cannot cope with the disease, then inflammation of the tonsils begins.

When is surgery needed?

In the recent Soviet past, removal of adenoids was a completely ordinary operation. And in America, almost all children under six years old had their adenoids (or tonsils) removed. Nowadays, adenoid removal is performed much less frequently, because there are a number of problems associated with such an operation. unpleasant consequences for the body.

• If a person gets a sore throat ( acute inflammation palatine tonsils) more than four times a year, and the disease occurs with high temperature and general weakness of the body.
• The occurrence of chronic tonsillitis against the background of constant tonsillitis (irreversible changes in the functioning of the tonsils and their constant inflammation.)
• Development against the background of this disease purulent abscesses(ulcers) affecting the larynx area.
• When there is an unconscious closure of the airways by large tonsils (snoring during sleep, which causes short-term cessation of breathing).
• A sharp weakening of the immune system.

Chronic tonsillitis, which is one of the main reasons for surgery to remove tonsils, is pathological condition body. The natural functions of the tonsils to protect against infections are lost during such a disease, and the tonsils themselves become the focus of inflammatory processes.

Progressive chronic tonsillitis can provoke diseases of the heart, joints and disrupt everything protective forces body. It can also cause rheumatism and severe kidney disease.

But early tonsillitis is perfectly treatable conservative methods(rinsing, lubrication, physiotherapeutic procedures, etc.). In case of failure of treatment of chronic tonsillitis inflammatory process goes too far and the damaged tonsils no longer contain healthy lymphoid tissue.

How is tonsils removed?

Nowadays, tonsil removal is performed using gentle methods and using modern equipment.

1. Partial removal of adenoids.

Inflamed lesions are exposed to ultra-low (freezing with liquid nitrogen) or ultra-high (cauterization with infrared or carbon laser) temperatures. After the damaged tonsil or part thereof dies, it is directly removed.

This operation is absolutely painless. But the tonsils are only partially removed, so in postoperative period The patient suffers for some time from a sore throat and a slight increase in temperature.

Electrocoagulation. Damaged and destroyed tonsils are exposed to high-frequency electric current. The operation is painless and bloodless. But application electric current may adversely affect healthy tissue surrounding the damaged tonsil. There may be some complications after surgery.

Ultrasonic excision. Tissue cutting to remove tonsils is performed using high-frequency sound vibrations, this operation is good because neither the blood vessels nor nearby tissues are damaged.

2. Complete removal adenoids (glands).

Mechanical removal tonsils in adults. Using surgical scissors and a wire loop. This operation is performed under general anesthesia and is accompanied by slight bleeding.

Immediately after surgery, the patient is placed on his right side, with an ice pack placed on his neck (cold helps to narrow the blood vessels and prevents bleeding from occurring). Over the next few days, the patient takes a course of antibiotics to prevent a possible infection.

On the first postoperative day, you are allowed to drink a few sips of water, next days you will have to limit yourself to pureed and liquid food in cold form. Five days later, the wound surface heals after the tonsils are removed.

Contraindications for surgery:

• Presence of blood diseases (deterioration of clotting).
• Heart problems (angina and tachycardia).
• Kidney diseases.
• Diabetes mellitus.
• Severe forms of hypertension.
• Active form of tuberculosis.
• Acute infectious diseases.
• Pregnancy in the third trimester (after six months).

Cardiologists and gynecologists (in cases with women) are categorically against surgery to remove tonsils. The body is greatly weakened by the loss of tonsils.

Consequences and complications of such an operation^

After a tonsillectomy (any operation, even the most gentle), complications may begin.

• The body is now less protected from pathogenic microorganisms After removal of the tonsils, the immune system is greatly weakened.
• The tissues of the pharynx and larynx experience severe stress, which manifests itself as a sharp constant pain in the throat.
• Possibility of dangerous bleeding.
• Spread of infection to the neck lymph nodes(lymphadenitis). This complication subsides a week after tonsil surgery to remove them.

Should I delete or not?

This issue should be resolved by a qualified and experienced doctor. The decision to undergo surgery is made only as a last resort when other types of treatment do not help. In this case, the harm and danger of chronic tonsillitis outweighs the complications after surgery.

Removing your adenoids is a last resort. If a person suffering from chronic tonsillitis begins to have problems with internal organs, then without a doubt, surgery to remove the tonsils is necessary. Tonsillectomy is performed only when the tonsils begin to work against their own body.

In any case, in modern pharmacology there are strong antibiotics. We have at our disposal numerous folk remedies and homeopathy. Our health and well-being of the body largely depends on its integrity.

To remove or not to remove tonsils? First of all, try to treat them and not let things take their course. Temper your own body, take it in the off-season vitamin complexes. Any operation is a serious change in the body and it is better to do without surgical measures. By the way, removing tonsils in adults is much more difficult than in children. An adult body is rarely completely healthy.

Take care of yourself and don't get sick!