Definition of Operation Performed Tonsillectomy (ton-sih-LEK-tuh-mee) Is The Surgical Removal of The Tonsils, Two Oval-Shaped Pads of

Definition of operation performed
Tonsillectomy (ton-sih-LEK-tuh-mee) is the surgical removal of the tonsils, two oval-shaped pads of
tissue at the back of the throat — one tonsil on each side.
A tonsillectomy was once a common procedure to treat infection and inflammation of the tonsils
(tonsillitis). Today, a tonsillectomy is usually performed when tonsillitis occurs frequently or doesn't
respond to other treatments.
A tonsillectomy may also be necessary to treat breathing and other problems related to enlarged tonsils
and to treat rare diseases of the tonsils.
Recovery time for a tonsillectomy is usually at least a week.
Discussion of Anatomy involved
Tonsils are located laterally in the oropharynx. The tonsils are bordered by the following tissues:
Deep - Superior constrictor muscle
Anterior - Palatoglossus muscle
Posterior - Palatopharyngeus muscle
Superior - Soft palate
Inferior - Lingual tonsil
Blood supply is through the external carotid artery and its branches, as follows:
Superior pole
Ascending pharyngeal artery (tonsillar branches)
Lesser palatine artery
Inferior pole
Facial artery branches
Dorsal lingual artery
Ascending palatine artery
Venous outflow is handled by the plexus around the tonsillar capsule, the lingual vein, and the
pharyngeal plexus. Lymphatic drainage involves the superior deep cervical nodes and the jugulodigastric
nodes. Sensory supply is provided by the glossopharyngeal nerve and the lesser palatine nerve.
Important structures deep to the inferior pole include the glossopharyngeal nerve, the lingual artery,
and the internal carotid artery. The tonsil surface is filled with crypts lined with squamous epithelium.
Lymphoid cells underlie the epithelium.
Function of organs/ body parts involved
Function of tonsils
 It monitors the quality of the air, food and water which enter our body
 It plays a major role in body immunity mechanism and antibody reaction most probably in
childhood
 It is helpful in forming lymphocytes (white blood cells) which protect our body as a defence
mechanism.
 It becomes as red swollen inflamed mass (danger light) indicating any infection entering our
body
 It traps the germs that enter the body by its antibodies and drains it into the lymph node for
elimination
 It is also supposed to kill bacteria that enter into the tonsil through the blood stream.
If we ignore the red light of tonsil, the infection might spread in the throat, mouth, sinuses and upper
respiratory tract. If we delay, the infection spreads further to the lower respiratory tract (lungs),
digestive tract and other parts of the body (joints, heart, etc.) With repeated attack of infection, the
tonsils may get fibrosis and scarred and lose its protective function.
Etiology of the disease
The most common causes of tonsillitis are the common cold viruses (adenovirus, rhinovirus, influenza,
coronavirus, respiratory syncytial virus). It can also be caused by Epstein-Barr virus, herpes simplex virus,
cytomegalovirus, or HIV. The second most common causes are bacterial. The most common bacterial
cause is Group A β-hemolytic streptococcus (GABHS), which causes strep throat. Less common bacterial
causes include: Staphylococcus aureus, Streptococcus pneumoniae, Mycoplasma pneumoniae,
Chlamydia pneumoniae, pertussis, Fusobacterium, diphtheria, syphilis, and gonorrhea.
Under normal circumstances, as viruses and bacteria enter the body through the nose and mouth, they
are filtered in the tonsils.Within the tonsils, white blood cells of the immune system mount an attack
that helps destroy the viruses or bacteria, and also causes inflammation and fever. The infection may
also be present in the throat and surrounding areas, causing inflammation of the pharynx. This is the
area in the back of the throat that lies between the voice box and the tonsils.
Tonsillitis may be caused by Group A streptococcal bacteria,resulting in strep throat. Viral tonsillitis may
be caused by numerous viruses such as the Epstein-Barr virus (the cause of infectious mononucleosis) or
adenovirus.
Sometimes, tonsillitis is caused by an infection of spirochaeta and treponema, in this case called
Vincent's angina or Plaut-Vincent angina.[12]
Signs and Symptoms

 Common symptoms of tonsillitis include:[2][3][4][5]
 red and/or swollen tonsils
 white or yellow patches on the tonsils
 tender, stiff, and/or swollen neck
 bad breath
 sore throat
 painful or difficult swallowing
 cough
 headache
 sore eyes
 body aches
 fever
 chills
 nasal congestions
Acute tonsillitis is caused by both bacteria and viruses and will be accompanied by symptoms of ear pain
when swallowing, bad breath, and drooling along with sore throat and fever. In this case, the surface of
the tonsil may be bright red or have a grayish-white coating, while the lymph nodes in the neck may be
swollen.
Intra and post op risk factors

 Reactions to anesthetics. Medication to make you sleep during surgery (general anesthesia)
often causes minor, short-term problems, such as headache, nausea, vomiting or muscle
soreness. Serious, long-term problems are rare.
 Swelling. Swelling of the tongue and soft roof of the mouth (soft palate) can cause breathing
problems, particularly during the first few hours after the procedure.
 Bleeding during surgery. In rare cases, severe bleeding occurs during surgery and requires
additional treatment and a longer hospital stay.
 Bleeding during healing. Bleeding can occur during the healing process, particularly if the scab
from the wound is dislodged too soon. Emergency surgery to stop the bleeding is riskier than
scheduled surgeries that allow for appropriate pre-surgical safeguards, such as fasting.
 Infection. Rarely, surgery can lead to an infection that requires further treatment.
Discussion of the Procedure

The generally accepted procedure for tonsillectomy involves separating and removing the tonsils from
the subcapsular plane – a fascia of tissue that surrounds the tonsils.[17] Removal is typically achieved
using a scalpel and blunt dissection or with electrocautery, although harmonic scalpels or lasers have
also been used. Bleeding is stopped with electrocautery, ligation of sutures, and the topical use of
thrombin, a protein that induces blood clotting.
The procedure is carried out with the patient lying flat on their backs, with the shoulders elevated on a
small pillow so that the neck is hyperextended – the so-called 'Rose' position. A mouth gag is used to
prop the mouth open; if an adenoidectomy is also being performed, the adenoids are first removed with
a curette; the nasopharynx is then packed with sterile gauze. A tonsil is removed by holding it by the
upper part, pulling it slightly medially, and making a cut over the anterior faucial pillar. After the tonsil is
removed from its position, a snare can be used to make a small cut on the lower portion prior to
removal of the tonsil. The use of electrocautery minimizes the blood loss

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Definition of operation performed

Discussion of Anatomy involved

Function of organs/ body parts involved

Etiology of the disease

Signs and Symptoms

Intra and post op risk factors

Discussion of the Procedure

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