Tonsillectomy and Adenoidectomy

Tonsillectomy and adenoidectomy are surgical procedures performed to remove the tonsils and adenoids.  These tissues are collections of lymphoid glands that sit in the back of the throat (tonsils) or nose (adenoids). Infected or enlarged tonsils may cause chronic or recurrent sore throat, bad breath, dental malocclusion, abscess, upper airway obstruction, difficulty with swallowing, snoring, or even sleep apnea. Infected adenoids may become enlarged, obstruct breathing, cause ear infections, sinusitis or other nasal problems.

Chronic Tonsillitis

Tonsillectomies are performed on patients who have had recurrent or chronic tonsillitis, which begin as a severe sore throat associated with fever, headaches, chills and muscle pain. Tonsillitis is the inflamed condition of the tonsils due to infection. The adenoids are located high in the rear of the throat, behind the nasal cavity. Together, the tonsils and the adenoids form a ring of tissue that probably helps build an immunity to bacteria entering the throat area. The crypts and crevices of the tonsils and adenoids sometimes become filled with bacteria and old cells, which accumulate and cause infection and swelling. Tonsil stones may form as a result of trapped bacteria and food debris, which can also cause a bad smell (halitosis).  The tonsils and adenoids may become permanently so enlarged that they interfere with breathing and swallowing. It is not always necessary to remove both the tonsils and the adenoids; however, they often become infected together and are usually removed at the same time.

Often these surgeries are done as an outpatient and you can return home the same day.  Please review postoperative instructions.

Laryngoscopy

Laryngoscopy is an examination that lets your doctor look at the back of your throat, your voice box and vocal cords with a scope called a laryngoscope.

Flexible laryngoscopy is usually done in the office under local anesthesia with minimal discomfort.  It allows a real time look at the anatomy and function of the voice box and the back of the throat.  Rarely biopsies can be done with this scope.  You may have some numbness for up to an hour or so afterwards due to the medications but otherwise the discomfort is minimal.

Direct laryngoscopy is using a rigid metal tube to look at the voice box and the back of the throat. This is usually done under general anesthesia.  This allows manipulation of these areas, including biopsies and careful inspection for tumors or other abnormalities.  Typically you can go home the same day.

Microlaryngoscopy is similar to laryngoscopy but a microscope or telescope is used to provide magnification.   This allows more careful manipulation of the tissues, such as removal of small cysts of the vocal cords or other procedures that involve precise and delicate movements.

Vocal cord surgery can be done if there is a concern of a growth or tumor on the cords or for some voice problems.  Your surgeon will review restrictions with you, but often time strict voice rest is necessary after surgery.

Bronchoscopy

Bronchoscopy is a procedure during in which an examiner uses a viewing tube to evaluate the airway for diagnostic and therapeutic purposes. A specialized scope is inserted through the mouth or nose to examine the airways for any abnormalities.  Photographs and tissue samples may be taken during the procedure for abnormalities, bleeding, tumors or inflammation.

Uvulopalatopharyngoplasty

UPPP is a surgical procedure used to treat sleep apnea. It is often combined with a tonsillectomy.  The purpose of the procedure is to remove excess or redundant soft tissue in the back of the throat in the hopes that it will prevent or reduce the collapse of those tissues that can contribute to the airway obstruction occurring during sleep.Uvulopalatopharyngoplasty

The surgery is done under general anesthesia.  Often times you can go home the same day, but usually you will be observed overnight to make sure there are no issues with your sleep apnea.  Discuss with your surgeon if you should continue to use your CPAP during recovery from surgery.  Typically one to two weeks off is necessary. Your swallowing will feel different but should eventually return to normal.  Your surgeon will discuss risks and expectations of surgery with you.  The postoperative care is similar to that of a tonsillectomy.

Uvulectomy

A uvulectomy is a surgical procedure in which all or part of the uvula is removed. The uvula is a bell-shaped organ that hangs from the top of the throat. Typically this is done in an attempt to reduce snoring, but some people need to have the uvula removed due to frequent infections or swelling of the uvula.  It is removed routinely as part of a UPPP (above).  It can be done under local or general anesthesia and usually you can go home the same day.

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