Dept. of ENT

Dr.Gangadhor M. - MS(ENT)

Dr.Akoijam Babie Anand - MS(ENT)

Abbreviation for ears, nose and throat. A field of medicine also called otolaryngology.

Otolaryngology: A medical and surgical specialty concerned with the diagnosis, management, and treatment of diseases and disorders of the ear, nose, throat (ENT) and related structures of the head and neck, including the sinuses, larynx (voice box), oral cavity, and upper pharynx (mouth and throat). Subspecialty areas within otolaryngology include pediatric otolaryngology (children), otology/neurotology (ears, balance, and tinnitus), allergy, facial plastic and reconstructive surgery, head and neck, laryngology (throat), and rhinology (nose). Some otolaryngologists limit their practices to one or more of these seven areas. Otolaryngology is commonly called ENT.

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In the picture above, the patient is in the Rose position (neck hyperextended and nasopharynx most dependent). A McIvor mouth gag props the mouth open and keeps the anesthesia endotracheal tube away from the surgical field. The right tonsil has been dissected with the coblator and retracted medially over the uvula. Note the dry tonsillar bed and total absence of blood in the field. The tonsil is finally severed from its attachement to the posterior pillar and removed.

What is Tonsils Removal Surgery (Tonsillectomy)?

A tonsillectomy is a surgical procedure to remove the tonsils in the back of the throat. The tonsils are part of the lymphatic system and help protect you from infection by trapping germs that may enter through your nose or mouth. Sometimes during tonsillectomy, the adenoids, also part of the lymphatic system, may be removed as well.


Who are candidates for Tonsils Removal Surgery (Tonsillectomy)?

Tonsillectomy may be recommended if you have:
- frequent bouts of acute tonsillitis (inflammation of the tonsils).
- chronic tonsillitis, consisting of persistent, moderate-to-severe throat pain.
- multiple bouts of peritonsilar abscess (severe infections in the throat area).
- sleep apnea (stopping or obstructing breathing at night due to enlarges tonsils or adenoids).
- difficulty eating or swallowing due to enlarged tonsils.

What are alternatives to Tonsils Removal Surgery (Tonsillectomy)?

Initially, tonsillitis may be treated with antibiotics. Surgery is considered after proper consultation with the doctor and have determined that tonsillectomy is appropriate for you.

How do you prepare for Tonsils Removal Surgery (Tonsillectomy)?

Prior to any surgery, doctor will give a complete medical examination and evaluate overall health and health history. Additional tests such as X-rays and lab tests may be required. The Doctor will also review the potential risks and benefits of the operation and will ask to sign a consent form.

It is important that you ask questions and be sure you understand the reason for the surgery as well as the risks.
It is important that you inform your doctor if you have allergies to any medications, what medications you are taking, and if you have bleeding problems. It is also important to inform your doctor if you are pregnant.
Your doctor will also give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.

Depending on the circumstances of your surgery, you may be instructed to do the following:
- Completely empty your colon and cleanse your intestines prior to surgery. You may be requested to drink clear liquids only for one or several days prior to surgery.
- Stop eating or drinking after midnight the night before the operation except medications that your doctor has told you are permissible to take with a sip of water the morning of surgery.
- Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. - - Allow for time to rest and try to find people to help you with your day-to-day duties.
- Stop smoking at least six to eight weeks prior to surgery as smoking delays wound healing. Smokers are also more likely to have breathing problems during surgery.

What is the Tonsils Removal Surgery (Tonsillectomy) recovery process?

You may go home later that day or stay in the hospital overnight and go home the next day, depending on your condition. You will have a sore throat and be uncomfortable for about seven to ten days. It will hurt to swallow. Spend this time at home and avoid all strenuous activity for at least two weeks.
Ask your doctor about what else you can do to have a successful recovery and schedule a follow-up appointment.

There are various ways to perform a tonsillectomy, ranging from a tonsillectomy under local anesthesia, which is carried out while the patient is awake in a sitting or semi-sitting position, to tonsillectomy under general anesthesia, where the patient is fully asleep. The surgical techniques and instruments also vary according to the surgeon's training and preference. Some surgeons still use the scalpel and snare, others use the coblator and some use the electric knife (Bovie electrocautery). Blood vessels are electrocoagulated / coblated, tied or sutured.

A common denominator to all these techniques is the dissection of the tonsillar capsule away from the surrounding muscles and achieving good hemostasis. With the popular use of electrocautery and coblation, blood loss has been reduced to a few milliliters and even to no bleeding at all. With no blood in the pharynx and no swallowed blood in the stomach, patients recover much better from anesthesia and vomit less. In addition, the use of coblation is becoming more popular because it seems to cause less post-operative pain.