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Tonsillectomy and Adenoidectomy

The tonsils and adenoids are masses of immune cells commonly found in lymph glands (lymphoid tissue). These tissues are located in the mouth and behind the nasal passages, respectively. Infected or enlarged tonsils may cause chronic or recurrent sore throat, bad breath, dental malocclusion, abscesses, upper airway obstruction causing difficulty with swallowing and snoring, or sleep apnea. Infected adenoids may become enlarged, obstruct breathing, cause ear infections or other problems. Tonsillectomy and Adenoidectomy are surgical procedures performed to remove the tonsils and adenoids.

PROCEDURE

After the anesthetic takes effect, the doctor will remove the tonsils and/or adenoids through the mouth. There will be no external incisions. The base of the tonsils and/or adenoids will be burned (cauterized) with an electrical cauterizing unit. The whole procedure usually takes less than 60 minutes. The generally accepted procedure for tonsillectomy involves separating and removing the tonsils from the subcapsular plane – a fascia of tissue that surrounds the tonsils. Removal is typically achieved using a scalpel and blunt dissection or with electrocautery, although harmonic scalpels or lasers are also being used.

The procedure is carried out with the patient lying flat on their backs, with the shoulders elevated on a small pillow so that the neck is hyper-extended – the so-called 'Rose' position. A mouth gag is used to prop the mouth open; if an Adenoidectomy is also being performed, the adenoids are first removed with a curette; the nasopharynx is then packed with sterile gauze. A tonsil is removed by holding it by the upper part, pulling it slightly medially, and making a cut over the anterior faucial pillar. After the tonsil is removed from its position, a snare can be used to make a small cut on the lower portion prior to removal of the tonsil.