Tonsil Surgery: Pain, Why, What Risks?

If tonsillectomy had been performed about twenty years ago, it would have been much less systematic today. Indications, risks, side effects … Dr. Patrick Aube, point with the general practitioner.

Also called tonsillectomy. “Tonsillectomy“Where”TonsillectomyDecisions can be made when they block the airways

What are tonsils for?

Tonsillectomy, sometimes called tonsillectomy, is the surgical removal of the tonsils. While it is true that tonsils play an important role in immunity, they can also block the airways. It exists Three types of tonsils: paltal and lingual (the ones you are looking at) And Pharyngeal tonsils (Plants) All are lymphoid organs of the larynx. Genuine The body’s protective barrier, They resist infection in the same way as lymph nodes. In case of infection, the tonsils become swollen.

Image of tonsils 123rf

When should tonsils be removed?

In children, tonsilllectomy repeatedly raises concerns about palatine tonsil removal in cases of angina or especially chronic tonsillitis. It is often associated with adenoidectomy where the pharyngeal tonsils or adenoids are removed. In young children (under 6 years of age), the main indications areChronic respiratory obstruction related to enlarged tonsils. In 2020, the French Society of ENT and Face and Neck Surgery (SFRL) updated its recommendations on pediatric tonsillectomy and clarified that Tonsillectomy is not recommended for the treatment of common runny nose And he didn’t Also not recommended for the treatment of recurrent angina or pharyngitis in children Happening in its frequency Less than 7 infectious episodes last year, Or less than 5 episodes / year in last 2 years, or less than 3 episodes per year in last 3 years.

Excessively large tonsils

Large tonsils Prevents you from breathing properly And well swallowed, often indicating 80% of cases of tonsilllectomy. It is then often associated with an adenoidectomy, i.e. removal of the vegetation. Its appearanceInsomnia This is also often observed caused by very large tonsils. When the tonsils are too large, they can actually partially block the airways, causing Sniff Including shortness of breath with shortness of breath. Children stay tired all day, and there can be problems at school. On the other hand, when tired, they are less likely to eat, especially if the tonsils sometimes prevent swallowing and the growth slows down. Then tonsillectomy often has very positive results on the physical and mental health of her children.

Repeated angina

20% tonsilllectomy is performed for angina or abscess. Recurrent angina is one of the main infectious signs. But the operation It’s not Children are not recommended for the treatment of recurrent angina or pharyngitis Happening in its frequency Less than 7 infectious episodes last year, Or of Less than 5 episodes / year in last 2 years, Or of Less than 3 episodes per year for the last 3 years. If a tonsillectomy is needed, it is best to do it Always get a second opinion, Without the appearance of an emergency such as a phlegmon or an abscess. Phlegmon and tonsil abscesses can cause shortness of breath that requires urgent intervention.

Acute articular rheumatism

The Acute articular rheumatism, AAR: This pathology occurs a few weeks later Angina caused by Streptococcus. It damages the joints, heart and membranes around certain organs like the pleura located around the lungs. Diagnosis is confirmed by a blood test, a local sample, an X-ray, an ultrasound. RAA represents a Real urgency Requires rapid care and treatment, including an antibiotic, corticosteroids, and strict rest. A prophylactic treatment usually consists of regular injections of penicillin.

Chronic tonsillitis

“Pharyngeal pain, bad breath, swollen tonsils, cervical lymph nodes last at least three months but require medical intervention” “General practitioners,” says Dr. Patrick Aubrey.

Tonsil removal in adults

Adults do not have tonsillectomy It is performed only when it is needed for medical reasons.

The operation is performed under General anesthesia And stays with antibiotic therapy. Intervention (20 to 30 minutes) The trachea is performed with intubation. Intervention is carried out Passing the instrument by mouth. Tonsillectomy can be done On an outpatient basis in children Post-tonsillectomy bleeding is detected either before or after the sixth day of discharge. However, not all patients may benefit from surgery on an outpatient basis.

What are the side effects of tonsil removal?

Of Sometimes the pain is hard to bear This can happen within a few days of surgery. “Especially painful dysphagia prevents food “, Says Dr. Aube. Paracetamol treatment can reduce pain. Playing ice cream is soothing Pain. It is recommended to do Eat fluids for a few days. “Children may need hospitalization for dehydration“, Underlining the general practitioner and specifying: “You should know that tonsilllectomy can happen Bleeding which is quite frequent After this intervention, in generalWithin six hours Which follows, which corresponds to the minimum period of careful observation of the person conducting.

What are the risks after tonsillectomy?

“The risk of surgery is not negligible” In a 2012 summary the Haute Autorité de Santé estimated.

Immediate risk

  • Tongue, small bump on the lips (benign).
  • Ear pain without the same gravity.
  • Some blood-stained spit.

Secondary risk

  • Bleeding is rare within 8 to 15 days after the operation. It must be treated quickly and any bleeding, even minimal, must be reported to the surgeon, SNORL reported.
  • Difficulty eating can interfere with painkiller intake, or even lead to malnutrition and dehydration: this must be reported to the surgeon quickly.
  • After healing, air leaks at the level of the soft palate and changes in the voice can be noticed. They may need speech therapy.

Severe and / or exceptional complications

An exceptional complication must be reported:Big bleeding, Which occurs during surgery or at the stage of healing. It can impose an operation at the level of the neck to run hemostasis and diagnose vital diseases. The risk of this Death The hemorrhagic source was estimated at 1 / 50,000 according to HAS.

  • Children need to be special Follow-up for the first 10 days Healing
  • A liquid and cold meal is recommended in the days following the operation to limit the risk of pain and bleeding.
  • May cause fever and bleeding. Consult a doctor.
  • Monitor the baby’s temperature and the absence of bleeding.
  • It is strongly recommended to fight the prognostic causes of chronic tonsillitis in order to avoid tonsillectomy as much as possible in adults.
  • Keep allergens away and treat any allergies.
  • Do not smoke until cured and avoid passive smoking.
  • Consult in case of sinus tenderness or recurrent nasal tenderness.
  • It is essential to treat any engine and maintain impeccable oral hygiene.

Source:

Medical Information Before Tonsillectomy, SNORL, 2017.

Tonsillectomy in children. 2020 update of SFORL and CFC recommendations.

Tonsillectomy with or without adenoidectomy in children or adolescents (under 18 years of age). Literary data synthesis December 2012. There

Dr. Patrick Aubrey, thanks to the general practitioner.

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