Tonsillitis causes Symptoms, Tonsillitis Treatment Tonsillectomy Indications
Tonsils are the lymphoepithelial tissues present in the area between oropharynx and nasopharynx. Tonsils are the immunocompetent cells provides immunity to body with first line defense mechanism against ingested foreign bodies.
Tonsillitis is the inflammation of the tonsils. Bacterial infection is the main causes of tonsillitis. Severe cases of tonsillitis need tonsillectomy. Tonsillectomy is a surgical removal of tonsils. Occationaly the adenoids are removed along with surgery.
Acute tonsillitis and chronic tonsillitis are the two main types of tonsillitis. Acute tonsillitis is caused by bacteria or virus and sub acute tonsillitis is caused by actinomyces bacteria. Chronic tonsillitis has a gradual onset and prolonged duration of disease. Pus formation may occur with chronic tonsillitis.
Causes of tonsillitis
Bacterial and viral infections are the main causes of tonsillitis. Tonsils have the main function of providing immunity to body by producing antibodies during an invasion of virus or bacteria into body. The WBC cells present in tonsils helps fight against infective organisms.
Common causes that lead to of tonsillectomy are the Infections caused by
- Streptococcus bacteria
- Staphylococcus bacteria and
- Viruses .
Group A streptococcal bacteria is the main causative organism responsible for tonsillitis and it may leads to pharyngitis.
Adenovirus causes viral tonsillitis.
Symptoms of tonsillitis
- Severe sore throat is the main symptom of tonsillitis.
- Difficulty in swallowing is the main problem associated with tonsillitis.
- Fever and chills originate with tonsil infection and inflammation.
- Dry cough, headache, muscles ache are also the symptoms of tonsillitis.
- The bacterial tonsillitis may show skin rash in some individuals.
- Viral tonsillitis may have symptoms such as runny nose and common cold symptoms.
Medical treatment of tonsillitis
- Antibiotic medications are prescribed to treat tonsillitis.
- Untreated tonsillitis may cause upper respiratory tract infection and lower respiratory tract infection.
- Relieving tonsil pain is the main objective of treatment.
- Antibiotics such as erythromycin and clarithromycin are widely used. Penicillin and Cephalosporins are the good choice of drugs used to treat tonsillitis.
- Chronic tonsillitis may need surgical removal of tonsil and is called as tonsillectomy.
Indications for Tonsillectomy
- Enlarged tonsils that cause upper airway obstruction, severe dysphagia, sleep disorders, or cardiopulmonary complications
- Peritonsillar abscess that is unresponsive to medical management and drainage documented by surgeon, unless surgery is performed during acute stage
- Tonsillitis resulting in febrile convulsions
- Frequent onset of acute tonsillitis. If it is, even severe, is generally not enough for most surgeons to decide tonsillectomy is necessary or not
Occurrence of chronic tonsillitis, with signs of of persistent, moderate-to-severe throat pain. - Multiple episodes of peritonsillar abscess.
- Sleep apnea (Patient is not able breath properly at night due to breathing)
- Difficulty in eating or swallowing due to enlarged tonsils.
- Presence of tonsillitis in the back of their mouth.
Abnormally large tonsils with crypts
Incidence of Tonsillectomy
Tonsillectomy is usually performed in children and also performed in teenagers and adults. Enlarged tonsils are removed more often among adults and children to get relief from sleep apnea, snoring, and upper airway obstruction associated with tonsillitis.
Food after tonsillectomy
Avoid spicy foods and snacks after tonsillectomy for five to seven days.
Cool and soft energetic drinks are suggested to enhance better healing.
Hydrate the oral cavity often and often to avoid pain in throat.
Methods of Tonsillectomy
A review of each procedure of tonsillectomy includes
Dissection and snare method of tonsillectomy
Removal of the tonsils by use of a forceps and scissors with a wire loop called a ‘snare’ is the most common method practiced by otolaryngologists today. The patient undergoes general anesthesia; the tonsils are completely removed and the skin is cauterized. The client will leave with minimal post-operative bleeding.
Electrocautery tonsillectomy
Electrocautery burns the tonsillar tissue and assists in reducing blood loss through cauterization. The heat of electrocautery, 400°C results in thermal injury to surrounding tissue. This may result in more discomfort during the postoperative period.
Harmonic scalpel method of tonsillectomy
Harmonic scalpel method uses ultrasonic energy to vibrate its blade at 55kHz. Invisible to the naked eye, the vibration transfers energy to the tissue, providing simultaneous cutting and coagulation. The temperature of the surrounding tissue reaches 80°C. Proponents of this procedure assert that the end result is precise cutting with minimal thermal damage.
Radiofrequency ablation method of tonsillectomy
Tonsillectomy can be performed in minor operation theater under mild sedation or local anesthesia. Mono polar radio frequency thermal ablation transfers radio frequency energy to the tonsil tissue through probes inserted in the tonsil. After the treatment is performed, scarring occurs within the tonsil causing it to decrease in size over a period of several weeks.. Tonsillar tissue remains after the procedure but is less prominent. This procedure is recommended for treating enlarged tonsils and not chronic or recurrent tonsillitis. The treatment can be performed several times. The advantages of this technique are minimal discomfort, ease of operations, and immediate return to work or school
Thermal Welding method of tonsillectomy
A new technology which uses pure thermal energy to seal and divide the tissue. The absence of thermal spread means that the temperature of surrounding tissue is only 2-3 °C higher than normal body temperature. Clinical papers show patients with minimal post-operative pain (no requirement for narcotic pain-killers), zero edema plus almost no incidence of bleeding. Hospitals in the US are advertising this procedure as “Painless Tonsillectomy”. Also known as Tissue Welding.
Carbon dioxide laser tonsillectomy
Laser tonsil ablation (LTA) finds the otolaryngologist employing a hand-held CO2 or KTP laser to vaporize and remove tonsil tissue. This technique reduces tonsil volume and eliminates recesses in the tonsils that collect chronic and recurrent infections. This procedure is recommended for chronic recurrent tonsillitis, chronic sore throats, severe halitosis, or airway obstruction caused by enlarged tonsils.
The LTA is performed in 15 to 20 minutes in an office setting under local anesthesia. The patient leaves the office with minimal discomfort and returns to school or work the next day. Post-tonsillectomy bleeding may occur in 2-5% of patients. Previous research studies state that laser technology provides significantly less pain during the post-operative recovery of children, resulting in less sleep disturbance, decreased morbidity, and less need for medications. On the other hand, some believe that children are adverse to outpatient procedures without sedation.
Microdebrider method of tonsillectomy
The microdebrider is a powered rotary shaving device with continuous suction often used during sinus surgery. It is made up of a cannula or tube, connected to a hand piece, which in turn is connected to a motor with foot control and a suction device.
The endoscopic microdebrider is used in performing a partial tonsillectomy, by partially shaving the tonsils. This procedure entails eliminating the obstructive portion of the tonsil while preserving the tonsillar capsule. A natural biologic dressing is left in place over the pharyngeal muscles, preventing injury, inflammation, and infection. The procedure results in less post-operative pain, a more rapid recovery, and perhaps fewer delayed complications. However, the partial tonsillectomy is suggested for enlarged tonsils – not those that incur repeated infections.
Bipolar Radio frequency Ablation method of tonsillectomy
Bipolar Radio frequency Ablation method produces an ionized saline layer that disrupts molecular bonds without using heat. As the energy is transferred to the tissue, ionic dissociation occurs. This mechanism can be used to remove whole tonsil or a part of tonsil. Albation method of tonsillectomy is done under general anesthesia in the operating room to severe infected tonsils. This technique results in less pain, faster healing of wound and less duration of post operative days.
This is the information about tonsillitis, causes of tonsillitis, symptoms of tonsillitis, tonsillectomy, procedure and techniques of tonsillitis. All the information provided here is for self knowledge and self medication is not suggested.
By Skin Infection, June 29, 2010 @ 9:54 am
Nice Blog…Defined very well about the Causes, Symptoms & Treatment for Tonsillitis. Thanks for posting.
By srinivasa, November 27, 2010 @ 8:24 am
Yes. Is suggested to do tonsillectomy under local anesthesia.
Thanking you
Dr Srinivas Gowda
By nikkie alipio, December 1, 2010 @ 3:45 pm
thanks guys for making this site.. it really helps me in doing my case report:) you are all AMAZING!!