Lingual Tonsillectomy (&Pallatine?) TBD 3/10/15

In the case of lingual tonsillectomy, the most common reason for removal is recurrent or chronic infections, lingular tonsillar enlargement causing obstructive sleep apnea syndrome, or suspicion of malignancy. HOW IS IT PERFORMED? This procedure is usually performed under general anesthesia. A device holds the mouth open, and a clamp is applied to the tonsil. When the tonsil is pulled toward the center of the throat, it is easy to see where it sits on the palate musculature. An incision is then made in the lining of the palate overlying the tonsil. This incision can be made with scissors, knife, laser, or cautery. Once it is made, it exposes a loose tissue layer between the tonsil and the muscles of the palate. The dissection then proceeds in the plane of the soft tissue layer, in the process shelling the tonsil out. As there are five different arterial supplies to the tonsil, bleeding can be quite brisk. Electric cautery is usually employed to control any bleeding. In the case of lingual tonsillectomy, the mouth is held open by an instrument called a laryngoscope, which is an illuminated tube through which the lingual tonsils can be visualized and removed. The lingual tonsils rest at the back part of the tongue and are rather firmly attached to the posterior tongue musculature. They are separated from the tongue musculature using either laser or cautery. The advantage of these two tools is minimal bleeding. Once one lingual tonsil is removed, then a similar procedure is done on the other side. WHAT HAPPENS AFTER THE PROCEDURE? The care of a patient after either palatine or lingual tonsillectomy is identical. Regardless of what instrument is used to remove the tonsils, there is usually significant throat pain. In general, the older the patient, the greater the degree and the longer the duration of pain.