Tonsillectomy is the removal of the the tonsils and it is a surgical procedure. This is done when a patient presents with symptoms of frequent throat infection, continuous use of antibiotics, unable to swallow due to inflammation and to solve the problem of sleep Apnea. Other cases are where there is a Peritonsillar abscess, or the need to do a Tonsillectomy biopsy to diagnose any lymphomas.Cold knife Tonsillectomy is done with a surgical instrument which is called a snare. There is a wire fixed like a circle and made into an almond shape. When the tonsils are defined and ready to excise, the tonsils will be read to be cut with the snare wire. First the wire will be put around the tonsil and pulled into the snare and excised. Immediately after the excision the site will be packed with a long gauze soaked and squeezed in normal saline solution. This is done to arrest the bleeding and also to make the operated site clear and to look for any bleeders. Once one side is done and there is no bleeding then the next side is attempted and completed in the same method .
If there is bleeding the Electrocautery is used. This Electrocautery is the transferring high local energy to tissues, and heats the tissues. The result is the tissues clot thus arresting the bleeders. The surgeon will give good pain management as this post operative pain will be there as the Electrocautery is used. It is soft tissue and the healing process is difficult as there has been tissue trauma, but with modern pain killers and antibiotics this has made tonsillectomy surgery easy to handle. The cold knife tonsillectomy method should always be done as it excises the whole tonsils.
When both the sides are over then he surgeon will sit back a few minutes after packing the throat. The packing and swabbing of the tonsil cavity is done whit both partially wet cotton balls and then dry cotton balls. This waiting time will allow the body to do its functioning of clotting all the bleeders which ate tiny and does not need cauterization. All the specimens which are removed are sent to the Histopathology examination. The most important thing is the surgeon will count all the packing which he has done and he will make sure he takes the same count out. He will also check that there is nil bleeding and hen will tell the Anaesthetist that the patient can be reversed form Anaesthesia. Then the Anesthetist will look to see if there is any bleeding to make sure the surgeon has not missed out any bleed or if any fresh bleeding occurs.
There are contraindications to having a tonsillectomy done
Patients having blood disorders like Purpura, Lukemias, and Haemophilia. Diabetes and heart disease is also another cause. Women who are on oral contraceptive pills have a high risk of deep vein thrombosis after tonsillectomy. Children below the age of three have a great risk as their cardiopulmonary reserve is poor.