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Tonsil Problem: Types and Technique Options
Years ago, it was common for parents to avoid putting their kids through tonsillectomies; it was considered unnecessary pain by many, and there were no proven results. Now, many of those kids are adults with problems like snoring, throat infections, and halitosis. Adult tonsillectomies are a better option than they used to be because of new technologies. On The Early Show, we discussed these new techniques with Dr. Jonas Johnson.
Tonsils, being the body's first line of defense against disease, are easily infected. The following are some common problems:
Enlarged tonsils can lead to snoring or sleep apnea, which means waking up irregularly during sleep because of loss of respiration.
People with intact tonsils can have crypts, deep pockets in the tonsils that can catch food and cause pain.
Some people experience recurring infections. For children, if they are having upper respiratory infections that occur more than six times a year, having the tonsils removed should be considered an option. As for adults, if you experience 2 to 2 1/2 of these per year, you may benefit from removal.
While new techniques still leave several questions unanswered, they are performed with less discomfort, and make for a smoother healing period. The procedure can now be done as an outpatient service, which means you can go home the same day. Only 1 to 2 percent will experience bleeding a few hours after the surgery.
There is a possibility that bleeding could occur for some a week or two later when a scab falls off, but it should be minor.
Students should be back at school within 5 days, physical laborers may need 2 weeks. The following are the improvements to the standard procedure:
New Techniques
- Laser: This cutting beam coagulates small blood vessels as it cuts, which results in less bleeding. This is a removal procedure, the whole tonsil is taken out. There is some thought it may improve post-operative discomfort and could shorten recovery phase. The procedure does create a burning sensation, which can hurt.
- Radio Frequency: Relies on an electrosurgical instrument that produces pulses of heat.
Types
- Coblation the surgeon tries to remove just the center of the tonsil. The attempt with this procedure is to reduce collateral tissue damage. This removes about 90 percent of tonsil. Coblation is also used to reduce the size of the turbinates.
- Somnoplasty originally marketed for treatment of snoring. This needle-shaped radio frequency instrument has been used to shrink the tonsil. The tonsil is actually burned to shrink to about 70 percent of the original size. The question remains whether or not a reduced tonsil can still cause infections.
- Harmonic Scalpel: Cuts tissue with ultrasound vibrations. This method uses low temperatures so it won't burn other tissues.
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