Tonsillitis

Tonsillitis

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Your tonsils are small pads of tissue located at the back of the throat, one on each side.
Tonsils produce a type of white blood cell that helps fight infection. The tonsils are the immune system's first line of defense against bacteria and viruses that enter your mouth. As a result, they are particularly vulnerable to infection and inflammation. The problem is more common in children as, unlike an adult's immune system, a child's system has had less exposure to bacteria and viruses and has not yet developed an immunity to them.
When the tonsils get infected it leads to an enlargement of these glands and the development of the following symptoms:
  • Painful throat
  • Fever > 38⁰C with chills
  • Loss of appetite
  • Red and swollen tonsils - you can feel lumps on either side of your neck
  • Hoarse voice
  • Foul breath
  • Difficulty in swallowing or breathing
  • Children may have nausea, vomiting, and tummy pain.
 
Tonsillitis may be associated with the development of abscesses, ear infections or even difficulty in breathing if they are very large. 

What are the treatment options?

Most of the symptoms of tonsillitis subside within 3-5 days without any antimicrobial therapy.
 
Medications: Antibiotics like penicillin and amoxicillin are effective against bacterial infection. Antibiotics are not effective against viral infections. To relieve symptoms, analgesics and antipyretics are usually prescribed.
Home remedies may help provide relief from the symptoms.  
  • Take adequate rest.
  • Drink plenty of fluids to prevent dehydration.
  • Have soft and cold food items such as ice creams and jelly to soothe a painful throat.
  • Gargle 3 to 4 times a day using warm saltwater.
  • Use lozenges and throat sprays to relieve a sore throat.
  • Avoid smoking to prevent throat irritation.
Surgery
 
 
Tonsillectomy –is the surgical removal of the tonsils and is advised when there are frequent episodes of tonsillitis. Frequent is more than seven episodes a year or, more than five episodes a year in each of the preceding two years or, more than three episodes a year in each of the preceding three years. It may also be prescribed when there is a bacterial infection that does not improve with antibiotic treatment or there is a collection of pus that does not improve with treatment.
Tonsillectomy is a procedure that is simple and devoid of serious risk to the patient, but as with any surgical procedure, there is always a risk albeit small. One needs to be aware of this when getting ready for a tonsillectomy.
 
Risks
 
  • Reactions to anesthetics.Include minor problems such as headache, nausea, vomiting or muscle soreness. Serious problems are rare, though general anesthesia is not without the risk of death.
  • Bleeding during surgery.In rare cases severe bleeding occurs during surgery and requires additional treatment and a longer hospital stay.
  • Bleeding during healing.Bleeding can occur during the healing process, particularly if the scab from the wound is dislodged too soon.
  • Swelling.Swelling of the tongue and soft palate can cause breathing difficulties in the first few hours after the procedure.
  • Infection.Rarely, surgery can lead to an infection that requires further treatment.
 
You will need to prepare for surgery with the following:
  • Tonsillectomy is usually done as a daycare procedure. You should not eat or drink anything for at least 8-10 hours before surgery (from midnight the night before) and have a light dinner. Your surgeon will provide you with instructions regarding eating food and drinking liquids prior to reporting to the hospital.
  • Don't take aspirin or other medications containing aspirin for at least two weeks before surgery.
  • Plan for 10 days to two weeks or more of recovery time. Adults may need more time than children do.

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After the surgery:

Nearly everyone experiences pain after a tonsillectomy. You can feel better and prevent complications with the following:
  • Medications.Take pain medications as directed by your surgeon.
  • Fluids.It's important to get plenty of fluids after surgery to avoid dehydration. Cold juices and ice cream can help relieve the pain.
  • Food.Bland foods that are easy to swallow are best after surgery. Avoid acidic, spicy or hard foods as they may cause pain or bleeding.
  • Rest.Bed rest is important for several days after surgery. Avoid vigorous exercise and running for two weeks after surgery.
  • Talk to your doctor about any activities that should be avoided.
 
How soon can you return to normal activities?

The recovery time for adults is usually longer. You can start performing normal activities within 5 to 7 days. Some people may take up to 2 weeks to recover.  
 
If your child has undergone surgery, send him to school about a week after the surgery. Let your child take rest to recover quickly and to minimize contact with other children and prevent complications. 
 
When can the patient return home after tonsillectomy?

Tonsillectomy is usually performed as a day care surgery. It takes about an hour to complete the procedure. You may go home on the day of surgery. But if there are any complications, you may be asked to remain in hospital for an overnight stay.
 
 
What are the types of surgeries for tonsils?

There are several procedures by which tonsillectomy is performed.
1. Electrocautery tonsillectomy - Most of the tonsillectomies today are performed using this technique. Electrocautery removes tonsils and adenoids by burning away the tissue that attaches them to the underlying throat muscles.
2. Bipolar radiofrequency tonsillectomy - Biopolar radiofrequency, also known as coblation, is a way to remove tonsils and adenoids. Using this form of energy in a carefully controlled surgical process, the tissues of the tonsils and adenoids are separated while causing very little harm to the surrounding healthy tissue. 
3. Cold knife tonsillectomy – This surgical technique is one in which the surgeon removes the tonsils completely, using a scalpel.
4. Powered intracapsular tonsillectomy – It uses a “microdebrider” which is a shaving device with a small rotating tip to remove the tonsils. By this technique, nearly 90% of the tonsil tissue is removed.
5. Ultrasonic dissection tonsillectomy – With this technique, high-frequency vibrations are used to vibrate the blade of a specially designed scalpel which is used to remove the tonsils. 

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