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Tonsils and Tonsillectomies



Everybody knows about tonsils. But not everyone knows how many tonsils we have, what tonsils do or why they may need to be removed. Knowing the facts can help alleviate the fears of one facing a tonsillectomy.

There are four sets of tonsils. The adenoids or the nasopharyngeal tonsils, located at the back of the nose; the palatine or faucial tonsils, located at the sides of the pharynx which makes them the most visible ones; the lingual tonsils, at the base of the tongue; and the tubal tonsils, also located at the back of the nose surrounding the tube that connects the ear and the nose.

Tonsils are masses of tissue that are similar to the lymph nodes or "glands" found in the neck, groin, and armpits. They are located near the entrance to the breathing passages where they can catch incoming germs, which cause infections. They "sample" bacteria and viruses and can become infected themselves. Scientists believe they work as part of the body's immune system by filtering germs that attempt to invade the body, and that they help to develop antibodies to germs. This happens primarily during the first few years of life, becoming less important as we get older.

Tonsillitis occurs when tonsils become infected and swell. If you look at your throat with a flashlight, the tonsils may be red and swollen or have a white or yellow coating on them. Other symptoms of tonsillitis may include:
  • sore throat
  • pain or discomfort when swallowing
  • fever
  • swollen glands (lymph nodes) in the neck
Tonsils tend to reach their largest size near puberty, and they gradually undergo atrophy (becomes smaller) thereafter. However, they are largest relative to the diameter of the throat in young children, and surgical removal may be indicated if they are obstructing the airway or interfering with swallowing. Also, when tonsils become overly enlarged or inflamed they may need to be surgically removed. In older patients, asymmetric tonsils (one tonsil bigger than the other) may be an indicator of virally infected tonsils, or tumors such as lymphoma.
The surgical procedure to remove tonsils is called a tonsillectomy. The doctor may suggest tonsillectomy if you have one or more of the following:
  • persistent or recurrent tonsillitis or strep infections
  • swollen tonsils that make it hard to breathe
  • difficulty eating meat or chewy foods
  • snoring that might be affecting your daily activities
  • obstructive sleep apnea (a condition in which you may stop breathing for a few seconds at a time during sleep because the enlarged tonsils are partially blocking the airway)
Some doctors who are not ENT specialists are conservative on recommending the removal of tonsils, because, they say, removal decreases the power of the immune system. This has been, however, disproved by several studies showing no significant effect of tonsil removal in one's immune system.
Surgery, no matter how common or simple the procedure, is often frightening to anyone. You can help prepare yourself for surgery by knowing these facts.
During the tonsillectomy:
  • You will receive general anesthesia. This means the surgery will be performed in an operating room so that an anesthesiologist can monitor you.
  • You will be asleep for about 30-45 minutes.
  • The surgeon will get to the tonsils through your open mouth — no skin incisions or "neck openings".
You will wake up in the recovery area. In most cases here in the Philippines, the total time in the hospital is 2-3 days (Admission day, operation day, and 24 hours observation and recovery). However, patients who will have trouble breathing or show signs of bleeding will be returned immediately to the operating room, and may stay for a day more or two.

The typical recuperation after a tonsillectomy often involves a week or more of pain and discomfort due to the exposure of the throat muscles after the tonsils are removed.

http://www.kidshealth.org/parent/medical/ears/tonsil.html


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