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Adenotonsillectomy (Tonsil and Adenoid Removal)

Tonsil (tonsil) and adenoid (adenoid) surgeries are the most frequently performed surgeries in ENT.

In Which Situations Should It Be Taken:  Although it is sometimes easy to decide to remove the tonsil and adenoid, it sometimes requires following the patient for a certain period of time. Conditions that cause the decision to have surgery include:

-Frequent infections: The generally accepted situation is to have 3 or more infections per year in consecutive years.

  • Enlargement of the tonsils to make it difficult to swallow even if there is no infection
  • Unilateral growth of the tonsillar tissue (as it may be a sign of lymphoma or other malignant diseases)
  • Frequent accumulation on the tonsils that may cause bad breath
  • Enlargement of the adenoid tissue to impair breathing
  • Middle ear inflammation (otitis media) ) and hearing loss
  • Often causing sinusitis and lower respiratory tract problems

At What Age Should the Surgery Be Performed: There is no exact age for the surgery. The decision is made according to the harm caused to the patient. A common situation is that the patient is 3 years old for tonsil surgery. Adenoid removal can be done even at the age of 1 year.

How Tonsil and Adenoid Surgery Is Performed: Although local anesthesia is sometimes used for tonsil, removal of adenoid tissue requires general anesthesia. Removal of the tonsil is in the form of removing it together with the capsule around it with an appropriate incision. Adenoid surgery is in the form of scraping the enlarged tissue. The operation time is usually short and varies between 30-60 minutes. Hospitalization is usually not required after surgery. Sometimes, it may be necessary to stay in the hospital for 1 night, especially in terms of bleeding risk.

What are the Risks and Complications of the Surgery: Like any surgery, tonsil and adenoid surgeries can have risks and complications. Local or general anesthesia always carries some risks. However, developments in anesthesia techniques and drugs reduce this risk day by day. Apart from this, the most common complication is bleeding. Although it can sometimes reach serious dimensions, this problem is rarely seen with careful and meticulous study and appropriate follow-up of the patient. Pain is the most disturbing condition for the patient, especially in adult patients. There is a belief that pharyngitis occurs after surgery. This is a wrong thought. If the patients expect that there will be no sore throat after the tonsil is removed, they may be wrong. Existing pharyngitis has nothing to do with the removal of the tonsils. Sometimes they even increase the infected tonsillar pharyngitis.

What Should Be Considered After the Surgery: The most important rules to follow are related to nutrition. Cold and liquid foods should be chosen, especially in the first 3 days, as the possibility of bleeding is more. For this reason, foods such as cold milk, soup, fruit juice, pudding, ice cream are ideal. Vomiting of dark blood on the first day of surgery is normal and is related to swallowed blood during surgery. However, continuous red blood flow requires immediate referral to your doctor. From the 4th day, it is gradually passed to normal food. The patient’s unwillingness to eat because of the pain causes the continuation of the pain. Be sure to drink plenty of fluids. Mild fever is expected after surgery. It usually returns to normal with adequate fluid intake and antipyretic drugs. Sometimes patients apply to the doctor a few days after the operation and complain that inflammation develops in the tonsil area.

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