Tonsillitis surgery: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
m (Bot: Removing from Primary care)
 
(11 intermediate revisions by 4 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Tonsillitis}}
{{Tonsillitis}}
Please help WikiDoc by adding more content here.  It's easy!  Click  [[Help:How_to_Edit_a_Page|here]]  to learn about editing.


{{CMG}}
{{CMG}}{{AE}}{{USAMA}}


==Overview==
==Overview==
[[Chronic (medicine)|Chronic]] cases may indicate [[tonsillectomy]] (surgical removal of tonsils) as a choice for treatment.<ref name="pmid6700642">{{cite journal |author=Paradise JL, Bluestone CD, Bachman RZ, ''et al'' |title=Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials |journal=N. Engl. J. Med. |volume=310 |issue=11 |pages=674–83 |year=1984 |pmid=6700642 |doi=}} - Paradise studied 187 children with tonsillectomy or tonsillectomy and adenoidectomy.  91 children were randomly put in surgical and non-surgical groups.  The other 96 were place by parent’s choice.  The results favored the surgical group on reoccurrence of throat infections during their initial and second year follow-up where the data was collected.  While non-surgical groups did better in the long run.  13 out of the 95 surgical group encountered surgical complications after their second year follow up</ref>
[[Chronic (medicine)|Chronic]] cases may indicate [[tonsillectomy]] (surgical removal of tonsils) as a choice for treatment.<ref name="pmid6700642">{{cite journal |author=Paradise JL, Bluestone CD, Bachman RZ, ''et al'' |title=Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials |journal=N. Engl. J. Med. |volume=310 |issue=11 |pages=674–83 |year=1984 |pmid=6700642 |doi=}} - Paradise studied 187 children with tonsillectomy or tonsillectomy and adenoidectomy.  91 children were randomly put in surgical and non-surgical groups.  The other 96 were place by parent’s choice.  The results favored the surgical group on reoccurrence of throat infections during their initial and second year follow-up where the data was collected.  While non-surgical groups did better in the long run.  13 out of the 95 surgical group encountered surgical complications after their second year follow up</ref> Subacute tonsillitis (which can last between 3 weeks and 3 months) is caused by the bacterium ''[[Actinomyces]]''. Chronic tonsillitis, which can last for long periods if not treated, is almost always bacterial.
==Surgery==
 
===Indications for Tonsillectomy===
Following are the indications for [[tonsillectomy]]:<ref name="pmid12172229">{{cite journal| author=Darrow DH, Siemens C| title=Indications for tonsillectomy and adenoidectomy. | journal=Laryngoscope | year= 2002 | volume= 112 | issue= 8 Pt 2 Suppl 100 | pages= 6-10 | pmid=12172229 | doi=10.1002/lary.5541121404 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12172229  }} </ref>
*Recurrent [[tonsillitis]]
*Chronic [[tonsillitis]]
*Recurrent [[acute pharyngitis]]
*[[Obstructive sleep apnea]] due to hyperplasia of adenoids and tonsils
*[[Failure to thrive]]
*Hemorrhagic tonsillitis
*Suspicion for [[malignancy]]
 
The '''paradise criteria''' for tonsillectomy is<ref name="pmid6700642">{{cite journal| author=Paradise JL, Bluestone CD, Bachman RZ, Colborn DK, Bernard BS, Taylor FH et al.| title=Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials. | journal=N Engl J Med | year= 1984 | volume= 310 | issue= 11 | pages= 674-83 | pmid=6700642 | doi=10.1056/NEJM198403153101102 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6700642  }} </ref>
*3 episodes every year for more than 3 years or
*5 episodes every year for 2 years or
*7 episodes in a year


==Surgery==
===Pre-operative Medical Prophylaxis===
*Antibiotics are given before tonsillectomy to decrease the risk of infections after the surgery.<ref name="pmid9397626">{{cite journal| author=Weber RS| title=Wound infection in head and neck surgery: implications for perioperative antibiotic treatment. | journal=Ear Nose Throat J | year= 1997 | volume= 76 | issue= 11 | pages= 790-1, 795-8 | pmid=9397626 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9397626  }} </ref>
*[[Ampicillin/sulbactam]] or [[Clindamycin]] or [[amoxicillin-clavulanate]] or [[cefazolin]] can be used for this purpose<ref name="pmid9243262">{{cite journal| author=Johnson JT, Kachman K, Wagner RL, Myers EN| title=Comparison of ampicillin/sulbactam versus clindamycin in the prevention of infection in patients undergoing head and neck surgery. | journal=Head Neck | year= 1997 | volume= 19 | issue= 5 | pages= 367-71 | pmid=9243262 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9243262  }} </ref><ref name="pmid17296307">{{cite journal| author=Skitarelić N, Morović M, Manestar D| title=Antibiotic prophylaxis in clean-contaminated head and neck oncological surgery. | journal=J Craniomaxillofac Surg | year= 2007 | volume= 35 | issue= 1 | pages= 15-20 | pmid=17296307 | doi=10.1016/j.jcms.2006.10.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17296307  }} </ref>


===Tonsillectomy===
*The surgery associated with the removal of the tonsils is termed a tonsillectomy.  
*The surgery associated with the removal of the tonsils is termed a tonsillectomy.  
*Tonsillectomies are performed primarily on children that suffer from recurrent, acute bacterial tonsillitis.  
*[[Tonsillectomy|Tonsillectomies]] are performed primarily on children that suffer from recurrent, acute bacterial tonsillitis.  
*All other cases should consider first line therapy.  
*All other cases should consider first line therapy.  
*The criteria for a child to undergo a tonsillectomy consists of seven or more documented and treated episodes in the previous year.  
*The criteria for a child to undergo a tonsillectomy consists of seven or more documented and treated episodes in the previous year.  
Line 19: Line 37:
*Risk of postoperative hemorrhaging can be further lessened with the proper usage of sutures and ligatures.  
*Risk of postoperative hemorrhaging can be further lessened with the proper usage of sutures and ligatures.  
*Procedures involving lasers, mono or bipolar forceps, and coblation have displayed a higher risk of postoperative hemorrhaging. <ref name= NLM Tons"> Tonsillitis and sore throat in children. United States National Library of Medicine. National Institutes of Health. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273168/ </ref>
*Procedures involving lasers, mono or bipolar forceps, and coblation have displayed a higher risk of postoperative hemorrhaging. <ref name= NLM Tons"> Tonsillitis and sore throat in children. United States National Library of Medicine. National Institutes of Health. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273168/ </ref>
*Currently, partial removal remains the surgical option of choice.
===Post Opperative Complications===
The [[post operative complications]] may include:
*[[Postoperative fever|Fever]]
*[[Atelectasis]]
*[[Pneumonia]]
*[[Urinary tract infection]]
*[[Deep vein thrombosis]]
*[[Jaundice]]
*[[Sepsis]]
*[[Hyponatremia]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


[[Category:Needs content]]
[[Category:Needs content]]
[[Category:Inflammations]]
[[Category:Inflammations]]
[[Category:Disease]]
[[Category:Emergency mdicine]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Infectious disease]]
[[Category:Disease]]
[[Category:Otolaryngology]]
[[Category:Primary care]]
[[Category:Pediatrics]]
 
[[Category:Surgery]]
{{WH}}
{{WS}}

Latest revision as of 00:26, 30 July 2020

Tonsillitis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Tonsillitis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

USG

CT Scan

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Tonsillitis surgery On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Tonsillitis surgery

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Tonsillitis surgery

CDC on Tonsillitis surgery

Tonsillitis surgery in the news

Blogs on Tonsillitis surgery

Directions to Hospitals Treating Tonsillitis

Risk calculators and risk factors for Tonsillitis surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Chronic cases may indicate tonsillectomy (surgical removal of tonsils) as a choice for treatment.[1] Subacute tonsillitis (which can last between 3 weeks and 3 months) is caused by the bacterium Actinomyces. Chronic tonsillitis, which can last for long periods if not treated, is almost always bacterial.

Surgery

Indications for Tonsillectomy

Following are the indications for tonsillectomy:[2]

The paradise criteria for tonsillectomy is[1]

  • 3 episodes every year for more than 3 years or
  • 5 episodes every year for 2 years or
  • 7 episodes in a year

Pre-operative Medical Prophylaxis

Tonsillectomy

  • The surgery associated with the removal of the tonsils is termed a tonsillectomy.
  • Tonsillectomies are performed primarily on children that suffer from recurrent, acute bacterial tonsillitis.
  • All other cases should consider first line therapy.
  • The criteria for a child to undergo a tonsillectomy consists of seven or more documented and treated episodes in the previous year.
  • Other criteria may be met if five or more episodes occur in the two preceding years.
  • Hemorrhaging is a common, postoperative concern.
  • The least amount of hemorrhaging is associated with a cold dissection.
  • Risk of postoperative hemorrhaging can be further lessened with the proper usage of sutures and ligatures.
  • Procedures involving lasers, mono or bipolar forceps, and coblation have displayed a higher risk of postoperative hemorrhaging. [6]
  • Currently, partial removal remains the surgical option of choice.

Post Opperative Complications

The post operative complications may include:

References

  1. ↑ 1.0 1.1 Paradise JL, Bluestone CD, Bachman RZ; et al. (1984). "Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials". N. Engl. J. Med. 310 (11): 674–83. PMID 6700642. - Paradise studied 187 children with tonsillectomy or tonsillectomy and adenoidectomy. 91 children were randomly put in surgical and non-surgical groups. The other 96 were place by parent’s choice. The results favored the surgical group on reoccurrence of throat infections during their initial and second year follow-up where the data was collected. While non-surgical groups did better in the long run. 13 out of the 95 surgical group encountered surgical complications after their second year follow up
  2. ↑ Darrow DH, Siemens C (2002). "Indications for tonsillectomy and adenoidectomy". Laryngoscope. 112 (8 Pt 2 Suppl 100): 6–10. doi:10.1002/lary.5541121404. PMID 12172229.
  3. ↑ Weber RS (1997). "Wound infection in head and neck surgery: implications for perioperative antibiotic treatment". Ear Nose Throat J. 76 (11): 790–1, 795–8. PMID 9397626.
  4. ↑ Johnson JT, Kachman K, Wagner RL, Myers EN (1997). "Comparison of ampicillin/sulbactam versus clindamycin in the prevention of infection in patients undergoing head and neck surgery". Head Neck. 19 (5): 367–71. PMID 9243262.
  5. ↑ Skitarelić N, Morović M, Manestar D (2007). "Antibiotic prophylaxis in clean-contaminated head and neck oncological surgery". J Craniomaxillofac Surg. 35 (1): 15–20. doi:10.1016/j.jcms.2006.10.006. PMID 17296307.
  6. ↑ Tonsillitis and sore throat in children. United States National Library of Medicine. National Institutes of Health. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273168/

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Tonsillitis_surgery&oldid=1643934"