Adenotonsillectomy

It is said we have three sets of tonsils;

 

 

Palatine tonsils (as seen opposite - visualised in the oropharynx)

Lingual tonsils (on the base of tongue) 

Adenoids (tonsils of the nose) 

Collectively these tissues are known as Waldeyer's ring

Tonsillectomy 

 

Removal of the palatine tonsils. (seen in the oropharynx opposite)

 

Indications

 

Recurrent tonsillitis or quinsy, obstructive sleep apnoea, suspected malignancy.

 

Risks

 

Risks of hospital admission, anaesthesia, damage to teeth, jaw ache and click, neck ache, bleeding (7%) (may require blood transfusion (<0.5%)/return to theatre (2%)).

 

 

Lingual tonsillectomy

 

Removal of the lingual tonsils at the base of tongue (not seen in the diagram). It is possible to get lingual tonsillitis post palatine tonsillectomy and on rare occasions, a lingual tonsillectomy can be performed.

 

Adenoidectomy

 

Removal of the adenoidal tissue from the nasopharynx.

 

Indications

 

Nasal obstruction and purulent discharge in children, bilateral persistent or recurrent otitis media with effusion, obstructive sleep apnoea (with tonsillectomy).

 

Risks

 

Risks of hospitalisation, anaesthesia, bleeding (<1%) (may require blood transfusion/ return to theatre)

There are specific criteria that a patient should fulfill to fit the criteria for a tonsillectomy. The original SIGN guidelines for these can be found in the following PDF.

Indication for tonsillectomy