Tonsils and Adenoids
What are tonsils and adenoids?

Tonsils and adenoids are one part of a collection of immune specific cells making up the reticuloendothelial system. Small solitary units of this type are present in the mouth, throat, and esophagus and the entire digestive tract.

The tissue produces white blood cells which help to process information from the environment to help the body distinguish between self and non-self. This allows adaptation to the environment, especially in children. There are specific white blood cells in the tonsillar tissue known as B and T-lymphocytes. B cells make immunoglobulins which help to ward off infection. T-cells are part of the cell immune-surveillance system. They are also present in the spleen and lymph nodes. There are over 300 lymph nodes in the neck, and 1,000 in the body. T-cells ‘process’ material from the environment so the body can defend against pathogens. Both T-and B-cells are released into the blood as they are from all lymph nodes or the spleen.

"Divots" or crypts of the tonsil are lined with cells. Cells from the tonsil and the lining are shed into the crypt and into the mouth and swallowed. It is estimated over 100 million cells are shed this way a day. The purpose is not known.

There are 6 clusters of these types of cells known as tonsils. The two most common are the pharyngeal tonsils and the paired palatine tonsils. Tonsils and adenoids enlarge during childhood as an expression of an active defense mechanism. If they become too large they cause obstruction. Severe snoring, sleep apnea, and swallowing/eating disorders result. When tonsils are very large- they become immunologically incompetent, meaning they do not secrete helpful cells or immunoglobulins. No person has ever suffered an immune problem because of tonsil or adenoid removal!
 
Indications for Surgery
  • Airway obstruction

  • Obstructive Sleep Apnea

  • Hypertrophy causing Swallowing problems

  • Possible cancer

  • Probable indications for removal Recurrent Acute Tonsillitis-
    7 infections in one year / 5 infectons for 2 consecutive years / 3 for 3 years. Peritonsillar abscess Nasal obstruction causing dental malocclusion or speech problems!
Surgical Procedure

Removal of the tonsils and/or adenoids requires a general anaesthetic at a hospital or surgery center. Dr. Wladecki utilizes a device known as a Coblator (www.arthrocareent.com) which utilizes radiofrequency ‘waves’ to remove the tissue. This causes less trauma to the tissue, with less pain post-op. Dr. Wladecki also injects local anaesthetic into the surrounding area to help with post-op pain.
Complications
  • Pain, which results in dehydration. Fever post-op is usually because of dehydration. It is very common to have pain in the ear post-op. This is known as referred otalgia and does not mean an ear infection.

  • Bleeding. Bleeding is rare – approximately 1 in 100 to 500 cases. This usually happens about 4 to 9 days post–op. Sitting up reduces blood pressure. Gargling with ice water usually stops this in 3-5 minutes. If bleeding persists Dr. Wladecki wants to be notified, so he can arrange for care.
    The most important point: DON’T PANIC!!!!! Do not call 911 or go to the ER without calling Dr. Wladecki first!
After surgery

After surgery it is recommended to drink extra fluids. Popsicles, slushies, etc. ANY food or drink is okay if it is tolerated! Dr. Wladecki likes his patients to use ibuprofen (motrin, advil) 3-4x a day for the first 5 days. Avoid liquid pain meds as they are alcohol based. Prescription pain meds will also be available.

White spots in the throat are normal, DON’T LOOK IN THERE!!!!!!!!!!!

Activity: decrease activity for about 9 days. No heavy lifting, no running, no heavy exercise. This helps to prevent bleeding.
 

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