Related Subjects:
|Assessing Hearing Loss
|Benign Paroxysmal Positional Vertigo (BPPV)
|Cholesteatoma
|Epistaxis (Nosebleeds)
|Acute Mastoiditis
|Nasal polyps
|Peritonsillar Abscess (Quinsy)
|Acute Sinusitis
|Sudden Sensorineural Hearing loss (SNHL)
|Causes of Vertigo
📖 About
- 🔪 Tonsillectomy and adenoidectomy are among the oldest surgical procedures, dating back to before the 6th century.
- 🏛️ Aulus Cornelius Celsus, a Roman physician, first described tonsil removal - sometimes using his fingers!
- 💤 Today, procedures are performed under general anaesthesia to remove the palatine tonsils and/or adenoids, which are lymphoid tissues important in immune defence.
📌 Indications
- 🔁 Recurrent tonsillitis (often due to Strep or Staph infections).
- 😴 Tonsillar hyperplasia: airway obstruction, snoring, or obstructive sleep apnoea (OSA).
- 🤒 Peritonsillar abscess (Quinsy): esp. if recurrent or resistant to conservative care.
- 🧬 Malignancy: suspicion of carcinoma or lymphoma → biopsy/removal.
- 👶 Adenoidectomy: in children for recurrent otitis media with effusion or persistent nasal obstruction.
🛠️ Tonsillectomy Techniques
- ✂️ Extracapsular tonsillectomy: removes entire tonsil + capsule. Traditional, prevents recurrence but ↑ pain.
- 🔬 Intracapsular tonsillectomy: removes 90–95% of tissue, leaves thin capsule. Less pain & quicker recovery but small risk of regrowth.
- ⚡ Techniques vary: cold steel, electrocautery, coblation, surgeon preference & patient factors.
⚠️ Complications
- 🤕 Post-op pain: severe in adults → poor intake & dehydration.
- 🩸 Haemorrhage:
- ⏱️ Primary (within 24h): uncommon but dangerous.
- 📆 Secondary (5–10 days): more common, linked to infection/sloughing of scabs.
- 🚑 Management: urgent review, fluids, cross-match blood, surgical haemostasis.
- 🦠 Infection: mild fever/inflammation; role of routine antibiotics debated.
- 💧 Dehydration: common in children due to pain & poor intake.
- 😮 Airway obstruction: rare but life-threatening if swelling/bleeding blocks airway.
- 🎤 Voice changes: altered resonance in children after adeno-tonsillectomy.
🩺 Postoperative Care
- 💧 Encourage hydration + analgesia (paracetamol + ibuprofen; avoid routine codeine in kids).
- 🏃♂️ Avoid strenuous activity/heavy lifting × 1–2 weeks.
- 🍲 Start with soft diet → gradual return to normal foods.
- ⚠️ Safety-net: advise urgent review if bleeding, high fever, or breathing difficulty.
📚 References
