With a chronic or recurrent tonsillitis (tonsillitis) and for further changes may be useful to the tonsils remove by surgery (tonsillectomy).
Causes of tonsillitis
Between the front and the rear arch of the palate are the two palatine tonsils (tonsils). They belong to the immune system of humans. At the tonsils can result in inflammation, the (influenzae, streptococci, staphylococci, Haemophilus influenzae, pneumococcus) is usually caused by bacteria. Most sufferers are children or young adults. Tonsillitis occur repeatedly in long-lasting (eg, four times in a row) or (chronic), it is recommended in many cases, a surgical tonsillectomy.
Often displayed a tonsillectomy is also enlarged tonsils, which constrict the throat (tonsils, hyperplastic).
Furthermore, a tonsillectomy may be indicated if the patient is facing a difficult transplant procedure, such as a heart transplant. Also, the surgery can be useful in diseases such as rheumatic fever. Sometimes even the suspicion of a tumor of the tonsils, so that may be made in some cases, a tonsillectomy for histological examination.
Until about four years a complete tonsillectomy should only be used in an emergency (eg Mandelabszess, an encapsulated purulent inflammation) occur, because the tonsils are responsible for training the body's own defense of the child is very important.
In tonsillitis pain and discomfort when swallowing exist. Also speaking is difficult. Because the inflammation is usually fever, the patient feels tired and sick. It may develop Mandelabszess an encapsulated purulent inflammation that extends deep into the tissue. By the abscess may eventually result in a dangerous spread of infection throughout the bloodstream (sepsis). The immune system is weakened by the abscess, so that may arise other diseases.
Mandel magnification (hyperplastic tonsils) of the throat is constricted, so that speech, swallowing and breathing impaired. It can result in a cessation of breathing during sleep (sleep apnea).
It is a survey of patients (medical history) and a physical examination with sampling of the lymph nodes and examination of the throat. In tonsillitis, the tonsils are swollen and red. A blood test is required.
Differential Diagnosis
Tonsillitis must be distinguished from other infections and diseases of the area. On the floor of an almond magnification can be a benign or malignant tumor.
Therapy
Conservative therapy
Tonsillitis is treated primarily by antibiotic drugs. The choice of agent depends on the particular pathogen. It can be given further analgesic medication.
Operation
The tonsillectomy can be performed under local anesthesia or general anesthesia.
There are basically two methods: the removal of the tonsils in the traditional way (tonsillectomy) and the reduction of the tonsils by laser beams (laser tonsillectomy).
For surgical removal of both tonsils (tonsillectomy), as is normally carried out at a tonsillitis, are separated out through the mouth at the head zurückgeneigtem almonds along with capsule from the surrounding tissue.
In a non-inflammatory almond magnification, especially with small children, other surgical procedures are performed.
It can, for example, only one can be taken out instead of the two palatine tonsils, while the other is left.
Also, a laser tonsillectomy be performed. This is the part of each almond cut out by laser technology, which protrudes from the palate tissue. The rest of the remaining almonds. This not only defense intact tissue of the tonsils is still in the body, but it also prevents it comes to swallowing and breathing problems. Sleep apnea is also a (pauses in breathing during sleep) prevented.
If enlarged adenoids or diseased, it can be removed separately. This can be done in the same procedure on the mouth, and then a ring-like scalpel is used.
Possible extensions of operation
It may be necessary such as complications due to pre-surgical method of amendment or extension.
Complications
It can cause bleeding and bleeding from the surgical field. It is not excluding the possibility that even after several days of heavy bleeding occurs so that they must be stopped in an emergency operation to major blood loss and to prevent blockage of the airways. It can be damaged structures in the surgical field, for example, palate, uvula, tongue or teeth. By nerve damage can be in different areas of numbness or paralysis develop, eg in the tongue. Also, taste disturbance are possible. It can also lead to problems swallowing or speech disabilities. Pain can usually be alleviated with drugs. Infections and impaired wound healing can occur. Allergic reactions can not be excluded.
Note: This section can give only a brief outline of the most common risks, side effects and complications, and makes no claim to completeness. The conversation with the doctor can thus not be replaced.
Forecast
The complete removal of the tonsils to prevent re-infection and therefore complications. If there remain portions of the tonsils, there may still develop infections. A so-called side-line angina is then also possible.
The defenses are not weakened by the removal of the tonsils.
Notes
Before surgery
If necessary, medications that reduce blood clotting, for example, warfarin or aspirin ® ® omitted. This will be discussed with the treating physician.
When performing the surgery under local anesthesia four hours before may no longer eating and smoking, two hours before anything more to drink. In an operation under general anesthesia increases the amount of time.
After surgery
If the operation is performed on an outpatient basis, so pay attention to the patient that he may serve partly due to the remaining effect of the medication for 24 hours, no car, no transportation and no other machines themselves. Therefore he should be picked up. Significant decisions should also be postponed.
During the two days after surgery, the patient may take only liquids or soft foods. Foods that can irritate the surgical area, such as coffee, alcohol, sour fruit, or very spicy foods should be avoided. Likewise, smoking should be avoided. For two weeks should not be exercised too much physical activity, for example, must fail in children physical education. There should be only moderately hot shower. On hot baths, sun baths or saunas should be avoided. Vaccinations should not be made until six weeks after surgery in children.
Result may be abnormal, the signs of complications, the physician should be contacted as soon as possible. Particular attention should be paid to bleeding, because even after these days can still be so severe that it due to blood loss and airway obstruction are very dangerous. In young children should be seen regularly at a glance whether there is any bleeding.
Causes of tonsillitis
Between the front and the rear arch of the palate are the two palatine tonsils (tonsils). They belong to the immune system of humans. At the tonsils can result in inflammation, the (influenzae, streptococci, staphylococci, Haemophilus influenzae, pneumococcus) is usually caused by bacteria. Most sufferers are children or young adults. Tonsillitis occur repeatedly in long-lasting (eg, four times in a row) or (chronic), it is recommended in many cases, a surgical tonsillectomy.
Often displayed a tonsillectomy is also enlarged tonsils, which constrict the throat (tonsils, hyperplastic).
Furthermore, a tonsillectomy may be indicated if the patient is facing a difficult transplant procedure, such as a heart transplant. Also, the surgery can be useful in diseases such as rheumatic fever. Sometimes even the suspicion of a tumor of the tonsils, so that may be made in some cases, a tonsillectomy for histological examination.
Until about four years a complete tonsillectomy should only be used in an emergency (eg Mandelabszess, an encapsulated purulent inflammation) occur, because the tonsils are responsible for training the body's own defense of the child is very important.
In tonsillitis pain and discomfort when swallowing exist. Also speaking is difficult. Because the inflammation is usually fever, the patient feels tired and sick. It may develop Mandelabszess an encapsulated purulent inflammation that extends deep into the tissue. By the abscess may eventually result in a dangerous spread of infection throughout the bloodstream (sepsis). The immune system is weakened by the abscess, so that may arise other diseases.
Mandel magnification (hyperplastic tonsils) of the throat is constricted, so that speech, swallowing and breathing impaired. It can result in a cessation of breathing during sleep (sleep apnea).
It is a survey of patients (medical history) and a physical examination with sampling of the lymph nodes and examination of the throat. In tonsillitis, the tonsils are swollen and red. A blood test is required.
Differential Diagnosis
Tonsillitis must be distinguished from other infections and diseases of the area. On the floor of an almond magnification can be a benign or malignant tumor.
Therapy
Conservative therapy
Tonsillitis is treated primarily by antibiotic drugs. The choice of agent depends on the particular pathogen. It can be given further analgesic medication.
Operation
The tonsillectomy can be performed under local anesthesia or general anesthesia.
There are basically two methods: the removal of the tonsils in the traditional way (tonsillectomy) and the reduction of the tonsils by laser beams (laser tonsillectomy).
For surgical removal of both tonsils (tonsillectomy), as is normally carried out at a tonsillitis, are separated out through the mouth at the head zurückgeneigtem almonds along with capsule from the surrounding tissue.
In a non-inflammatory almond magnification, especially with small children, other surgical procedures are performed.
It can, for example, only one can be taken out instead of the two palatine tonsils, while the other is left.
Also, a laser tonsillectomy be performed. This is the part of each almond cut out by laser technology, which protrudes from the palate tissue. The rest of the remaining almonds. This not only defense intact tissue of the tonsils is still in the body, but it also prevents it comes to swallowing and breathing problems. Sleep apnea is also a (pauses in breathing during sleep) prevented.
If enlarged adenoids or diseased, it can be removed separately. This can be done in the same procedure on the mouth, and then a ring-like scalpel is used.
Possible extensions of operation
It may be necessary such as complications due to pre-surgical method of amendment or extension.
Complications
It can cause bleeding and bleeding from the surgical field. It is not excluding the possibility that even after several days of heavy bleeding occurs so that they must be stopped in an emergency operation to major blood loss and to prevent blockage of the airways. It can be damaged structures in the surgical field, for example, palate, uvula, tongue or teeth. By nerve damage can be in different areas of numbness or paralysis develop, eg in the tongue. Also, taste disturbance are possible. It can also lead to problems swallowing or speech disabilities. Pain can usually be alleviated with drugs. Infections and impaired wound healing can occur. Allergic reactions can not be excluded.
Note: This section can give only a brief outline of the most common risks, side effects and complications, and makes no claim to completeness. The conversation with the doctor can thus not be replaced.
Forecast
The complete removal of the tonsils to prevent re-infection and therefore complications. If there remain portions of the tonsils, there may still develop infections. A so-called side-line angina is then also possible.
The defenses are not weakened by the removal of the tonsils.
Notes
Before surgery
If necessary, medications that reduce blood clotting, for example, warfarin or aspirin ® ® omitted. This will be discussed with the treating physician.
When performing the surgery under local anesthesia four hours before may no longer eating and smoking, two hours before anything more to drink. In an operation under general anesthesia increases the amount of time.
After surgery
If the operation is performed on an outpatient basis, so pay attention to the patient that he may serve partly due to the remaining effect of the medication for 24 hours, no car, no transportation and no other machines themselves. Therefore he should be picked up. Significant decisions should also be postponed.
During the two days after surgery, the patient may take only liquids or soft foods. Foods that can irritate the surgical area, such as coffee, alcohol, sour fruit, or very spicy foods should be avoided. Likewise, smoking should be avoided. For two weeks should not be exercised too much physical activity, for example, must fail in children physical education. There should be only moderately hot shower. On hot baths, sun baths or saunas should be avoided. Vaccinations should not be made until six weeks after surgery in children.
Result may be abnormal, the signs of complications, the physician should be contacted as soon as possible. Particular attention should be paid to bleeding, because even after these days can still be so severe that it due to blood loss and airway obstruction are very dangerous. In young children should be seen regularly at a glance whether there is any bleeding.
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