Tonsillectomy ( part -02 ) ENT Lecture скачать в хорошем качестве

Tonsillectomy ( part -02 ) ENT Lecture

Tonsillectomy Definition : Tonsillectomy is the surgical removal of the palatine tonsils, usually performed for recurrent infection or airway obstruction. Indications (Very Important for Exam) : 1. Infective Indications Chronic tonsillitis Recurrent acute tonsillitis ≥ 7 attacks in 1 year, or ≥ 5 attacks/year for 2 years, or ≥ 3 attacks/year for 3 years Recurrent peritonsillar abscess (quinsy) Tonsillitis with complications: Rheumatic fever Acute glomerulonephritis 2. Obstructive Indications Sleep apnea Dysphagia Speech problems Failure to thrive (children) 3. Other Indications Suspicion of malignancy (unilateral tonsil) Recurrent cervical lymphadenitis Halitosis due to tonsillar crypt infection Contraindications : Acute tonsillitis (relative) Bleeding disorders Uncontrolled systemic illness Cleft palate (risk of velopharyngeal insufficiency) Age Commonly done between 5–15 years Can be done in adults if indicated Methods of Tonsillectomy : Cold steel dissection (most common) Electrocautery Coblation Laser tonsillectomy Complications : 1. Immediate Reactionary hemorrhage (within 24 hrs) Airway obstruction Anesthetic complications 2. Late Secondary hemorrhage (5–10 days) Infection Pain, dehydration Change in voice (rare) Post-operative Care : Adequate analgesia Soft, cold diet Maintain hydration Watch for bleeding Antibiotics if needed Key Viva Points : Most common complication → Hemorrhage Most dangerous complication → Reactionary hemorrhage Secondary hemorrhage usually due to infection