Tonsillectomy was 1st performed by a roman surgeon named Celsus 30 AD. Over time, different instruments have been used: snare, guillotine( the Sluder Ballenger).The last 30 years, an explosion of new modalities made the surgery somewhat safer and with less blood loss: -CO2 Laser -Bipolar Scissors -Coblation Technique -Harmonic Knife -Microdebrider(for intracapsular tonsillectomy) Tonsillitis The correct diagnosis is very important, that should include: sore throat, fever, and neck node swelling. . | Tonsillectomy Indications Complications Tonsillectomy was 1st performed by a roman surgeon named Celsus 30 AD. Over time different instruments have been used snare guillotine the Sluder Ballenger .The last 30 years an explosion of new modalities made the surgery somewhat safer and with less blood loss -CO2 Laser -Bipolar Scissors -Coblation Technique -Harmonic Knife -Microdebrider for intracapsular tonsillectomy Tonsillitis The correct diagnosis is very important that should include sore throat fever and neck node swelling. A differential diagnosis is in order before treatment or tonsillectomy is recommended -Infectious mononucleosis -Malignancy Lymphoma Leukemia Carcinoma -Diphteria Scarlet Fever Agranulocytosis -Syphilis Candidiasis The main indications for Tonsillectomy fall into 2 categories Infections and Hypertrophy with obstruction and occasionally for diagnosis of a primary CA Chronic Tonsillitis 3 or more episodes per year treated with antibiotics 2 or more positive cultures for streptococcus A . Halithosis caused by tonsilloliths accumulation of sulfur producing bacteria plus debris that are lodged in the tonsils crypts Hypertrophy of tonsils and adenoids causing malocclusion or obstructive sleep apnea Indications of Adenoidectomy . Recurrent adenoiditis 3 or more episodes per year . Recurrent serous otitis media on children with previous myringotomies and tubes. . Chronic nasal obstruction mouth breathing . Speech problems obstructive sleep apnea . Severe orofacial dental abnormalities. When performing a Tonsillectomy usually an Adenoidectomy is included T A But an Adenoidectomy could be performed separately if there is no true indication for a tonsillectomy. It should be noted that the Adenoids disappear after the age of 20-21. Chronic recurrent infections of tonsils and adenoids are mostly caused by
