Tonsillectomy is defined as the surgical excision of the palatine tonsils - the most prominent Tonsils just behind the teeth.
Indications:
I. Absolute
II. Relative
I. Absolute Indications
- Recurrent infection of throat: 7 or more episodes In 1 year or 5 episodes per year for 2 years or 3 episodes per year for 3 years
- 2 weeks or more of lost school or work in 1 year ·
- Peritonsillar abscess : In child -Done after 4-6 weeks after abscess has been treated. In adult - 2nd attack
- Tonsillitis causing Febrile seizures
- Hypertrophy of tonsils causing :
- 1. Airway obstruction
- 2. Difficulty in deglutition
- 3. Interference with speech
- 4. Suspicion of malignancy - In unilaterally enlarged tonsil suspect lymphoma in children and carcinoma in adults
II. Relative Indications
- Diphtheria carriers, who do not respond with antibiotics
- Streptococcal tonsillitis with bad taste or halitosis which is unresponsive to medical treatment
- Recurrent streptococcal tonsillitis in a patient with valvular heart disease.
The American Academy ofOtolaryngology– Head and Neck Surgery (AAO-HNS)
Absolute indications
- Enlarged tonsils that cause upper airway obstruction, severe dysphagia, sleep disorders, or cardiopulmonary complications
- Peritonsillar abscess that is unresponsive to medical management and drainage documented by surgeon, unless surgery is performed during acute stage
- Tonsillitis resulting in febrile convulsions
- Tonsils requiring biopsy to define tissue pathology
Relative indications
- Three or more tonsil infections per year despite adequate medical therapy
- Persistent foul taste or breath due to chronic tonsillitis that is not responsive to medical therapy
- Chronic or recurrent tonsillitis in a streptococcal carrier not responding to beta-lactamase resistant antibiotics
- Unilateral tonsil hypertrophy that is presumed to be neoplastic
Contraindication
Anemia (Hb↓10g%)
Acute infections
Bleeding diathesis; leukaemia,purpura, aplastic aneamia, hemophilia
Overt or submucous cleft palate
Children < 3 years of age
Uncontrolled systemic disease
Picture Courtesy Stanford Health
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