Overview
Tonsillectomy is a surgical procedure to remove the tonsils, commonly performed for recurrent tonsillitis, sleep apnea, or other tonsillar conditions.
Tonsillectomy is crucial for treating recurrent infections, obstructive sleep apnea, and improving quality of life in affected patients.
Learn more in our comprehensive RxDx ENT Course
Indications
Multiple episodes per year
Obstructive sleep apnea
Peritonsillar abscess
Airway obstruction
Persistent infection
Contraindications
Absolute Contraindications
Relative Contraindications
📋 Equipment Checklist
Check off items as you gather them:
Pre-procedure Preparation
Preparation includes patient assessment, anesthesia planning, equipment setup, and understanding contraindications.Step-by-Step Procedure
Step 1: Patient Preparation
Position patient, administer anesthesia.
⚠️ Common Mistakes to Avoid:
- Poor positioning
- Inadequate anesthesia
💡 Pro Tip:
Use proper positioning.
Step 2: Mouth Gag Placement
Insert mouth gag for exposure.
⚠️ Common Mistakes to Avoid:
- Poor exposure
- Tongue injury
💡 Pro Tip:
Protect tongue and teeth.
Step 3: Tonsil Dissection
Dissect tonsil from bed.
⚠️ Common Mistakes to Avoid:
- Incomplete removal
- Bleeding
💡 Pro Tip:
Use proper technique.
Step 4: Hemostasis
Control bleeding from tonsillar bed.
⚠️ Common Mistakes to Avoid:
- Inadequate hemostasis
- Post-op bleeding
💡 Pro Tip:
Ensure complete hemostasis.
Step 5: Bilateral Procedure
Repeat for opposite tonsil.
⚠️ Common Mistakes to Avoid:
- Asymmetric removal
- Incomplete procedure
💡 Pro Tip:
Ensure symmetry.
Step 6: Post-procedure Care
Monitor and provide instructions.
⚠️ Common Mistakes to Avoid:
- Poor monitoring
- Inadequate instructions
💡 Pro Tip:
Provide clear instructions.
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Post-procedure Care
Post-procedure care involves pain management, hydration, monitoring for bleeding, and dietary restrictions.Complications & Management
Complication | Incidence | Signs | Management | Prevention |
---|---|---|---|---|
Bleeding | 2-5% | Active bleeding, hematemesis | Return to OR, cautery | Proper hemostasis |
Infection | 1-3% | Fever, pain, foul odor | Antibiotics | Sterile technique |
Dehydration | 5-10% | Poor intake, lethargy | IV fluids | Encourage hydration |
Velopharyngeal insufficiency | 1-2% | Nasal regurgitation | Speech therapy | Proper technique |
Clinical Pearls
Use proper mouth gag positioning.
Ensure complete hemostasis.
Monitor for post-op bleeding.
Check for residual tonsillar tissue.
Document procedure details.
Provide clear post-op instructions.
Be prepared for emergency management.