Removal of tonsils (tonsillectomy)

The modern attitude towards tonsil removal is based on the methods developed in the late 19th and first half of the 20th centuries. provisions on the indications and contraindications for this operation, which are based on scientifically substantiated achievements of medical science in the field of hematology, the doctrine of toxic-allergic conditions of the body, focal infection and its role in the occurrence of diseases of internal organs, etc. When determining indications for tonsillectomy (removal of tonsils), the doctor must be proficient in the "dialectics of diagnostics", i.e. use the principle of old Russian doctors - "to think at the patient's bedside", which means an analytical approach to chronic tonsillitis (as well as to any other disease) and the upcoming treatment as a systemic process, which includes such factors as the general condition of the patient, the condition of his individual organs and systems, especially those with close anatomical and physiological connections with the object of surgical intervention, the choice of the optimal method of treatment, possible consequences of surgical intervention, etc. Often, such a correct approach to the development of tactics and strategy for treatment of chronic tonsillitis is replaced by the principle (or rather an unprincipled approach) of "no tonsils - no problem”, and the patient is “sentenced” to tonsil removal, which is not indifferent to his body but is unnecessary in many cases.

Tonsillectomy (removal of tonsils) under general anesthesia. Recently, tonsillectomy (removal of tonsils) under general intubation anesthesia has become increasingly widespread, the indications for which are determined by an ENT surgeon, and contraindications are assessed by an anesthesiologist. Most often, it is performed in childhood, when children are panicky afraid of surgery, or when they have certain diseases of the nervous system, manifested by hyperkinesis, epileptic seizures, etc. The same indications apply to adult patients, especially with an uncontrollable gag reflex. Preparation for general anesthesia is carried out under the supervision of an anesthesiologist, and during this period, vital functions of the body are corrected, the activity of the blood coagulation system is increased, and the body is saturate with essential vitamins. After the patient is put into a narcotic state, all stages of the operation are similar to those performed under local anesthesia. The patient's position is on his back with his head thrown back (drooping) as much as possible. The surgeon is in a sitting position behind the patient at his head, so the endoscopic picture of the pharynx is presented in an "inverted" form. It is also possible to operate in the traditional position of the doctor. The advantages of tonsillectomy (removal of the tonsils), performed under intubation anesthesia, are the complete absence of the pharyngeal reflex, the possibility of calm and careful manipulation in the surgical field and careful hemostasis. The absence of gagging sharply reduces vascular bleeding, and the ability to control blood pressure makes this operation safe even in patients with hypertension or suffering from renal or adrenal hypertensive syndrome.

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