Tonsillectomy

[albertO de ca]

dear friend, just want to share my experiences for an operation that i need to undergo. hope this topic can help some others who need information regarding this topic.thanks

As we know, Tonsil is one of the "protective" system for our sistems. However, for tonsils, generally it will shrink in size when we grow up and study has show that in older age, actually the function of tonsils as defense system o body is questionable. therefore, although we "lost" te tonsils, our body immune system will not being affected much.
normally tonsil will not cause any major problems. However, in certain circumstances, removal of tonsil is neccessary.
1. Recurrent Tonsilitis
2. Suspected lymphatic carcinoma
3. Causes respiratoy obstruction (snoring at night)
4. Causes significant sleep anpnea.
Due to the reason mention on top, the specialist will suggest tonsilectomy done.
tonsilectomy normally reffered to tonsilar removal. However, during the operation, the surgeon will ue a retrograde mirror to access and determine eitehr the adenoid tonsils need to be removed.
this operation will be under general anesthesia. Therefore, risk of GA need to be discuss well with the patient.
before operation, patient need to undergo pre-operation accessment, including of ECG, CXR, Blood investigation of Renal Profile, FBC, LFT and PT/APTT.
 If everything ok and the Medical and ENT surgeon satisfy with the condition of patient, they will put patient on the operation risk...
so far this is the information that i can provide. next time i will be back to this forum for further steps that they will do before and after the operation.
thanks
anyway, i will be admitted to hospital soon and i will try to remember what they are going to do for me and post it here fore sharing.
for the time being, thanks for reading ya...
take k

[cecilia]

Admitted? When & where?

[albertO de ca]

hey, Dr cecilia, thank you for your concern. yupe, i will be admitted on 17th, and op on 18th april. hope eveything goes well..
the operation will be at Selayang hospital, Malaysia.
keep us update with ur travel trips ya.
take k..
thank agin.

[drvolcanoe]

Albert...worry not. our prayers is with u.

look at the bright side...u get to eat ALL the ice-cream tat u want after the surgery

Just to share...i was ignorant that 'normal adult' tonsil should not be visible. only during one clinical skills unit (CSU) session in my pre-clinical yrs did i know tat mine was abnormal. no wonder as i am prone to URTI since a kid...

[albertO de ca]

Albert...worry not. our prayers is with u.

look at the bright side...u get to eat ALL the ice-cream tat u want after the surgery

Just to share...i was ignorant that 'normal adult' tonsil should not be visible. only during one clinical skills unit (CSU) session in my pre-clinical yrs did i know tat mine was abnormal. no wonder as i am prone to URTI since a kid...

thanks Dr Lava for ur concern and pray. hope everything goes well 
YA. normally in adult, the tonsils should shrink.. in ur case, i not sure either tat is the cause for ur RECURRENT sorethroat, but i assume it maybe related. normally asymptomatic tonsil enlargement, no sugical treatment needed. if u are worry regarding ur recurrent tonsilitis, maybe u can undergo the surgery also

anyway, thanks for the concern again ya!
may GOD bless u too! take k

best regards,
Albert Lee

[stabilo]

how do we place the ET tube when operating the tonsils?

[drvolcanoe]

YA. normally in adult, the tonsils should shrink.. in ur case, i not sure either tat is the cause for ur RECURRENT sorethroat, but i assume it maybe related. normally asymptomatic tonsil enlargement, no sugical treatment needed. if u are worry regarding ur recurrent tonsilitis, maybe u can undergo the surgery also

i'm not worried...just hope that in future i dont get ill too often or my patients will start asking me to go seek treatment :p

NO WAY! haha...i know u were kidding.
but have been under the surgical knife once before (2days in ward) at 16 yrs of age, and told myself I'll only return to wards as a doctor or visitor...never a patient again! Not because the staffs weren;t good or anything...but it was just TOO BORING!

how do we place the ET tube when operating the tonsils?

interesting Q! we'll wait for dr alb to tell us that

[paramedicdeb]

In Canada while doing throat surgery usually a nasotracheal tube is used not a ET tube to allow for visualization of the area being worked on.The only real side effect that most have post surgical intervention for tonsills is a sore throat and I have only seen a couple hemorrhage post surgery and that was cured with cautery. For your info all will go well and you will feel much better afterwards.

[cecilia]

I've seen a tonsillectomy done in Seremban Hospital where the patient was put under GA and an ET tube was inserted. It was still possible to do so (inserting the ETT) perhaps because his tonsils weren't big enough to kiss each other yet.

In Canada while doing throat surgery usually a nasotracheal tube is used not a ET tube to allow for visualization of the area being worked on.The only real side effect that most have post surgical intervention for tonsills is a sore throat and I have only seen a couple hemorrhage post surgery and that was cured with cautery. For your info all will go well and you will feel much better afterwards.

Otherwise, I believe that nasotracheal tube is an alternative to an ET tube. Personally, I've not seen it used for tonsillectomy YET. Perhaps that's because I've not seen enough tonsillectomy surgeries?  Maybe we should ask Albert to get his doctors to allow us to be in the OT during his surgery, and we all can have a wonderful teaching session on....Albert's tonsils. Who knows, one of us might just be lucky enough to have the honor of cutting Albert's tonsils. Hehehe.

[albertO de ca]

how do we place the ET tube when operating the tonsils?

haha.. friend, u got a good idea and questions regarding this. i am concern about this too.hehe.. but the doctor says it shoudnt be a problem coz they are using  the electric cut and will have no or minimal bleeding (if no complications).. so i think the ET tube should be still there, maybe smaller size one kua... or maybe they will cover with something?? hmmm interesting. i will ask the Anesthesiologist on the day of admission and update u all after i am back , ok?
hehe.. thanks


best regards,
Albert Lee

[albertO de ca]

I've seen a tonsillectomy done in Seremban Hospital where the patient was put under GA and an ET tube was inserted. It was still possible to do so (inserting the ETT) perhaps because his tonsils weren't big enough to kiss each other yet.

In Canada while doing throat surgery usually a nasotracheal tube is used not a ET tube to allow for visualization of the area being worked on.The only real side effect that most have post surgical intervention for tonsills is a sore throat and I have only seen a couple hemorrhage post surgery and that was cured with cautery. For your info all will go well and you will feel much better afterwards.

Otherwise, I believe that nasotracheal tube is an alternative to an ET tube. Personally, I've not seen it used for tonsillectomy YET. Perhaps that's because I've not seen enough tonsillectomy surgeries?  Maybe we should ask Albert to get his doctors to allow us to be in the OT during his surgery, and we all can have a wonderful teaching session on....Albert's tonsils. Who knows, one of us might just be lucky enough to have the honor of cutting Albert's tonsils. Hehehe.

hallo. thanks for giving advice on that.
about the ET tube, Dr Cecilia is right also, as long as small and still can visualize, it shouldnt be a problem.. however, for mine, i think it will be a BIG BIG problem as the tonsils grows together with my Size and leading to big big tonsils..hehe.. hmm thanks for paramedicdeb regarding the nasotracheal tube.. for mine, i also not sure.. coz they say my arynoid tonsil also enlarge and they will cut it too.. so as we know, those tonsils are located at the upper parts near the nose.. so i doubt they are able to intubate me using the tube..heh.e.. so, i will ask the doctors and let u all updates ya..hehe..thanks..
hmmm interesting that some of u like cecilia willing to see my tonsillectomy?? hmm sure got some "bad idea" of going into there one.. sure they will ask the surgeon :" soory Mr. XXX, i am Dr. XXX, can i assist u in the surgery?" NO WAY!! i sure will stress up..haha... just kidding.
sure, if u all get the permission to do so, i have no problem for u all to OBSERVE (yes, only OBSERVE) my operation..hehe.. can help me record down too   :

ok for the time being, countdown before my admission....

take k
wish me good luck

regards,
Albert Lee

[drvolcanoe]

cecilia! haha...good one there

how do we place the ET tube when operating the tonsils?

haha.. friend, u got a good idea and questions regarding this. i am concern about this too.hehe.. but the doctor says it shoudnt be a problem coz they are using  the electric cut and will have no or minimal bleeding (if no complications).. so i think the ET tube should be still there, maybe smaller size one kua... or maybe they will cover with something?? hmmm interesting. i will ask the Anesthesiologist on the day of admission and update u all after i am back , ok?
hehe.. thanks

maybe u can 'record' the op for us, find a way to update videos in this forum & share wif us all

And alb, i have witnessed a gynae surg performed on my mommy wen i was a 3rd yr medic student. it was back in hometown and the gynae himself nice enuff offer me if i wanna observe when he knew i'm a medic student

[Admin]

I am glad that Dr. Albert has started this toipic for us to discuss here

[albertO de ca]

And alb, i have witnessed a gynae surg performed on my mommy wen i was a 3rd yr medic student. it was back in hometown and the gynae himself nice enuff offer me if i wanna observe when he knew i'm a medic student

ya, Dr. Cecilia, so nice to get back from you.. is ur gynae sooo nice? hehe.. yupe, maybe u are a student and the FOR SURE u will be a great doctor one day, they see ur potential oredi..haha...
hmmm i dont mind if u all want to go in also.hehe.. just this is a government hospital, i think we not only needthe agreement from the surgeon, the head of department, but also need from the BOSS Pengarah.. hehe.. so i think not so easy to get the permission to go in loh..
anyway, i am now trying to mentally prepared for the op. thanks for concern.

best regards,
Albert Lee

[cecilia]

And alb, i have witnessed a gynae surg performed on my mommy wen i was a 3rd yr medic student. it was back in hometown and the gynae himself nice enuff offer me if i wanna observe when he knew i'm a medic student

ya, Dr. Cecilia, so nice to get back from you.. is ur gynae sooo nice? hehe.. yupe, maybe u are a student and the FOR SURE u will be a great doctor one day, they see ur potential oredi..haha...
hmmm i dont mind if u all want to go in also.hehe.. just this is a government hospital, i think we not only needthe agreement from the surgeon, the head of department, but also need from the BOSS Pengarah.. hehe.. so i think not so easy to get the permission to go in loh..
anyway, i am now trying to mentally prepared for the op. thanks for concern.

best regards,
Albert Lee

Albert, I think you got the wrong person. That was lavanya's reply to you. Not mine. He he.