Tonsillitis surgery: Difference between revisions
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*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. | *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== | ||
Revision as of 21:12, 21 March 2017
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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]
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]
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. [5]
- Currently, partial removal remains the surgical option of choice.
Post Opperative Complications
The post operative complications may include:
- Fever
- Atelectasis
- Pneumonia
- Urinary tract infection
- Deep vein thrombosis
- Jaundice
- Sepsis
- Hyponatremia
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/