Tonsillectomy is a surgical procedure primarily used to remove the tonsil tissue located in the pharyngeal region. This operation is typically indicated for severe cases involving recurrent inflammation, airway obstruction, or complications. The goal of the surgery is to eliminate the diseased tissue, prevent the spread of infection, or avoid sleep disturbances caused by airway blockage.
The surgical methods can be divided into traditional excision and modern energy device excision, selected based on patient age, frequency of inflammation, and severity of complications. The recovery period usually lasts about 1 to 2 weeks, during which close monitoring for bleeding or infection is necessary.
Traditional excision involves using surgical instruments to directly remove the tonsil tissue, with hemostasis achieved through sutures or cauterization. Newer techniques such as low-temperature electrocautery or laser can precisely cut tissue while reducing surrounding damage, resulting in less postoperative pain and bleeding risk.
The mechanism of the surgery is to thoroughly remove the diseased tissue, thereby breaking the cycle of bacterial accumulation and recurrent inflammation. For patients with sleep apnea caused by enlarged tonsils, removal of the tissue can restore airway patency.
The main indications include: more than 7 episodes of acute tonsillitis per year, more than 6 or 5 episodes depending on age standards, tonsil hypertrophy causing airway obstruction, or complications such as peritonsillar abscess.
The surgery is performed under general anesthesia, usually as an outpatient procedure. The surgeon inserts instruments through the mouth to remove tissue using either mechanical or energy devices, and performs hemostasis. The entire process lasts approximately 30 to 90 minutes, adjusted according to the patient's anatomy.
Postoperative dietary guidelines should be followed, starting with cold liquids and gradually progressing to normal foods. The use of antibiotics and analgesics should follow the physician’s prescription, with regular follow-up visits for monitoring.
The primary benefit is the definitive resolution of recurrent inflammation. Studies show that postoperative episodes of acute inflammation can be reduced by over 90%. For sleep apnea patients, postoperative improvements in blood oxygen levels and sleep quality are significant.
Common side effects include postoperative sore throat, difficulty swallowing, and low-grade fever. About 80% of patients develop a white membrane during healing. Serious risks include intraoperative or postoperative significant bleeding, with an incidence of approximately 1-2%, requiring immediate hospital readmission.
Rare cases may experience chronic throat foreign body sensation or taste disturbances. Pediatric patients should be aware of anesthesia risks. Postoperative infections or delayed healing may increase due to low immunity or non-compliance with care instructions.
Preoperative management includes discontinuing anticoagulants (such as aspirin) at least one week prior and controlling upper respiratory infections for at least two weeks. Contraindications include active bleeding disorders, recent cardiopulmonary infections, or uncontrolled metabolic diseases.
Postoperative care requires strict adherence to dietary restrictions, avoiding hot or coarse foods that may damage the surgical site. Strenuous activity should be prohibited within 10 days after surgery to prevent bleeding recurrence.
Interaction with antibiotics: Antibiotics should be completed at least 24 hours before surgery to avoid affecting intraoperative assessment. Postoperative antibiotics should follow the physician’s prescription to prevent antibiotic resistance.
Interaction with analgesics: Non-steroidal anti-inflammatory drugs (NSAIDs) may affect blood clotting and should be used according to medical advice regarding timing and dosage.
Large studies show that within one year after surgery, episodes of acute inflammation decrease by 85-95%, and the improvement rate for sleep apnea symptoms reaches 70-80%. Follow-up data over five years indicate a recurrence rate of less than 5%.
Compared with conservative treatments, surgical patients have a 60% reduction in missed school or work days. Cost-effectiveness analyses suggest that surgery has advantages when indications are met.
Conservative treatments include high-dose antibiotics and corticosteroid anti-inflammatory therapy, which only provide temporary symptom relief. Immunomodulatory therapies are still experimental and not widely available.
Some mild cases can be managed by boosting immunity or using topical mouthwashes, but recurrent episodes exceeding standard thresholds still warrant surgery to prevent complications.
Postoperative pain is usually managed with prescribed analgesics such as NSAIDs or mild opioids. Cold compresses on the neck and avoiding excessive activity can also alleviate discomfort. If pain persists or worsens beyond the effect of medication, consult a physician promptly.
What dietary restrictions should be followed after surgery? When can normal eating resume?For 1 to 2 weeks post-surgery, focus on cold liquids and soft foods such as smoothies, pudding, or porridge, avoiding hot, hard, or spicy foods. Using a straw to drink can reduce throat irritation. Typically, normal eating can gradually resume after 4 to 6 weeks, depending on individual recovery.
Is bleeding or fever normal after surgery? When should emergency care be sought?Minor bleeding or low-grade fever within 48 hours post-surgery may be normal. However, large amounts of fresh blood, persistent high fever (over 38.5°C), or difficulty breathing require immediate medical attention. Sudden heavy bleeding within two weeks may indicate tissue separation and warrants urgent care.
When can daily activities resume? What activities should be avoided?Rest for at least 1 to 2 weeks post-surgery, avoiding strenuous exercise or heavy lifting to prevent bleeding or delayed healing. High-intensity activities like running or swimming should be postponed for 2 to 4 weeks, depending on individual healing progress. Gradually increase light activities, avoiding exaggerated laughing or shouting.
Is it possible to have recurrent inflammation after surgery? What are the long-term risks?After gland removal, the risk of acute tonsillitis significantly decreases due to reduced throat tissue, but other upper respiratory infections may still occur. Long-term risks include poor healing or throat dryness, but these are rare. Regular follow-up can detect abnormalities early, such as persistent difficulty swallowing or airway obstruction.
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