Back استئصال اللوزتين Arabic Amigdalectomia Catalan Tonzilektomie Czech Tonsillektomie German ޓޮންސިލް ނެގުން DV Amigdalectomía Spanish لوزه‌برداری Persian Tonsillectomie French Amigdalectomía Galician ניתוח שקדים HE

Tonsillectomy

Tonsillectomy
Typical appearance of the back of the throat three days post tonsillectomy.
Other namesAdenotonsillectomy, T&A
ICD-9-CM28.2-28.3
MeSHD014068
MedlinePlus003013

Tonsillectomy is a surgical procedure in which both palatine tonsils are fully removed from the back of the throat.[1] The procedure is mainly performed for recurrent tonsillitis, throat infections and obstructive sleep apnea (OSA).[1] For those with frequent throat infections, surgery results in 0.6 (95% confidence interval: 1.0 to 0.1) fewer sore throats in the following year, but there is no evidence of long term benefits.[1][2] In children with OSA, it results in improved quality of life.[3]

While generally safe, complications may include bleeding, vomiting, dehydration, trouble eating, and trouble talking.[1] Throat pain typically lasts about one to two weeks after surgery.[1][4] Bleeding occurs in about 1% within the first day and another 2% after that.[1] Between 1 in 2,360 and 1 in 56,000 procedures cause death.[1] Tonsillectomy does not appear to affect long term immune function.[1][5]

Following the surgery, ibuprofen and paracetamol (acetaminophen) may be used to treat postoperative pain.[1] The surgery is often done using metal instruments or electrocautery.[1][6] The adenoid may also be removed or shaved down, in which case it is known as an "adenotonsillectomy".[1] The partial removal of the tonsils is called a "tonsillotomy", which may be preferred in cases of OSA.[1][7][8][9]

The surgery has been described since at least as early as 50 AD by Celsus.[10] In the United States, as of 2010, tonsillectomy is performed less frequently than in the 1970s although it remains the second most common outpatient surgical procedure in children.[1] The typical cost when done as an inpatient in the United States is US$4,400 as of 2013.[11] There is some controversy as of 2019 as to when the surgery should be used.[1][2] There are variations in the rates of tonsillectomy between and within countries.[12][13]

  1. ^ a b c d e f g h i j k l m n Mitchell RB, Archer SM, Ishman SL, Rosenfeld RM, Coles S, Finestone SA, Friedman NR, Giordano T, Hildrew DM, Kim TW, Lloyd RM, Parikh SR, Shulman ST, Walner DL, Walsh SA, Nnacheta LC (5 February 2019). "Clinical Practice Guideline: Tonsillectomy in Children (Update)". Otolaryngology–Head and Neck Surgery. 160 (1_suppl): S1–S42. doi:10.1177/0194599818801757. PMID 30798778.
  2. ^ a b Burton MJ, Glasziou PP, Chong LY, Venekamp RP (November 2014). "Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis" (PDF). The Cochrane Database of Systematic Reviews. 2014 (11): CD001802. doi:10.1002/14651858.CD001802.pub3. PMC 7075105. PMID 25407135. Adeno-/tonsillectomy leads to a reduction in the number of episodes of sore throat and days with sore throat in children in the first year after surgery compared to (initial) non-surgical treatment.
  3. ^ Venekamp RP, Hearne BJ, Chandrasekharan D, Blackshaw H, Lim J, Schilder AG (October 2015). "Tonsillectomy or adenotonsillectomy versus non-surgical management for obstructive sleep-disordered breathing in children" (PDF). The Cochrane Database of Systematic Reviews. 2015 (10): CD011165. doi:10.1002/14651858.CD011165.pub2. PMC 9242010. PMID 26465274.
  4. ^ Flint PW, Haughey BH, Robbins KT, Thomas JR, Niparko JK, Lund VJ, Lesperance MM (2014). Cummings Otolaryngology – Head and Neck Surgery E-Book. Elsevier Health Sciences. p. 2862. ISBN 9780323278201.
  5. ^ Cite error: The named reference Bit2015 was invoked but never defined (see the help page).
  6. ^ Damiani F, Rada G, Gana JC, Brockmann PE, Alberti G (2 September 2016). "Long-term effects of adenotonsillectomy in children with obstructive sleep apnoea: protocol for a systematic review". BMJ Open. 6 (9): e010030. doi:10.1136/bmjopen-2015-010030. PMC 5020755. PMID 27591015.
  7. ^ Zhang LY, Zhong L, David M, Cervin A (December 2017). "Tonsillectomy or tonsillotomy? A systematic review for paediatric sleep-disordered breathing". International Journal of Pediatric Otorhinolaryngology. 103: 41–50. doi:10.1016/j.ijporl.2017.10.008. PMID 29224763.
  8. ^ Gorman D, Ogston S, Hussain SS (2017). "Improvement in symptoms of obstructive sleep apnoea in children following tonsillectomy versus tonsillotomy: a systematic review and meta-analysis". Clinical Otolaryngology. 42 (2): 275–282. doi:10.1111/coa.12717. ISSN 1749-4486. PMID 27506317. S2CID 1784671.
  9. ^ Stelter K (1 December 2014). "Tonsillitis and sore throat in children". GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery. 13: Doc07. doi:10.3205/cto000110. ISSN 1865-1011. PMC 4273168. PMID 25587367.
  10. ^ Lamprell L, Ahluwalia S (April 2015). "Who has been hiding in your tonsillectomy tray? Eponymous instruments in tonsillectomy surgery". The Journal of Laryngology and Otology. 129 (4): 307–13. doi:10.1017/S0022215114003016. PMID 25658777. S2CID 42461145.
  11. ^ Sun GH, Auger KA, Aliu O, Patrick SW, DeMonner S, Davis MM (December 2013). "Variation in inpatient tonsillectomy costs within and between US hospitals attributable to postoperative complications". Medical Care. 51 (12): 1048–54. doi:10.1097/MLR.0b013e3182a50325. PMID 23969585. S2CID 22239630.
  12. ^ "Surgical operations and procedures statistics - Statistics Explained". ec.europa.eu. Retrieved 8 October 2019.
  13. ^ Cite error: The named reference Sul2010 was invoked but never defined (see the help page).

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