Tonsillitis surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
===Indications for Tonsillectomy=== | |||
*Recurrent [[tonsillitis]] | |||
*Chronic [[tonsillitis]] | |||
*Recurrent [[acute pharyngitis]] | |||
*[[Obstructive sleep apnea]] | |||
===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> | |||
*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. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Chronic cases may indicate tonsillectomy (surgical removal of tonsils) as a choice for treatment.[1]
Surgery
Indications for Tonsillectomy
- Recurrent tonsillitis
- Chronic tonsillitis
- Recurrent acute pharyngitis
- Obstructive sleep apnea
Pre-operative Medical Prophylaxis
- Antibiotics are given before tonsillectomy to decrease the risk of infections after the surgery.[2]
- Ampicillin/sulbactam or Clindamycin or amoxicillin-clavulanate or cefazolin can be used for this purpose[3][4]
- 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. [5]
- Currently, partial removal remains the surgical option of choice.
References
- ↑ 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
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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/