Tonsillectomy - Surgical Procedure

Surgical Procedure

For the past 50 years at least, tonsillectomy has been performed by dissecting the tonsil from its surrounding fascia, a so-called 'total', or more properly, an extra-capsular tonsillectomy. As has already been referred to, problems include pain and bleeding. More recently, interest in sub-total tonsillectomy or 'tonsillotomy' has returned in an effort to reduce the complications, and in the process turning the clock back 60 -100 years, albeit now with the advantages of modern technology. There are reports that complications may indeed be reduced.

It has already been stated that the benefits of tonsillectomy for sore throat are controversial and time limited. Consequently, the main question of importance becomes whether or not the benefits of subtotal tonsillectomy in obstructive sleep apnea are enduring. It appears that this may be the case although most observers agree that further time and study is required.

The generally accepted procedure for 'total' tonsillectomy in recent time has involved separating and removing the tonsils from the subcapsular plane – a fascia of tissue that surrounds the tonsils. Removal is typically achieved using a scalpel and blunt dissection or with electrocautery, although harmonic scalpels or lasers have also been used. Bleeding is stopped with electrocautery, ligation of sutures, and the topical use of thrombin, a protein that induces blood clotting.