Contraindications to tonsillectomy

The article was professionally consulted with Doctor CKII Nguyen Van Thai - Department of Medical Examination & Internal Medicine - Vinmec International General Hospital Da Nang.

Tonsillitis accounts for a high rate in children, the cause is usually caused by bacteria. When the tonsils are inflamed again and again, the immune system is weakened, which will trigger episodes of inflammation in the throat, causing dangerous complications. Many people choose surgical solutions, but it is also important to note the contraindications to tonsillectomy.

The tonsils are lymphocytes in the oropharynx that protect the body against pathogens. The tonsils are also the site of production of Immunoglobulin IgG antibodies that are important in immunity.
The tonsils as an immune barrier are usually active from the age of 4-10 years old. After the child reaches puberty, the immunity of the tonsils decreases completely and is no longer active.
What is tonsillitis?
When bacteria attack the nose and throat causing inflammation, swelling and redness not only reduce immunity but also form an accumulation of bacteria (Inflammation furnace: including bacterial corpses, white blood cells, necrotic tissue... ) harm. Tonsillitis is a common disease in Ear - nose - throat diseases, especially in children. Due to the recurrent nature of the disease, tonsillitis is easy to cause complications, affecting the patient's health and daily activities.
Complications of Tonsillitis:
Abscess around tonsils: sore throat, swollen throat, difficulty swallowing, speechless, high fever, headache, bad breath, drooling... Acute arthritis : manifestations of joint swelling, heat, redness of the wrists, knees, fingers and toes, fatigue and weakness. Complications of arthritis often lead to pericarditis (acute pericarditis, endocarditis, myocarditis), complications of otitis media. Glomerulonephritis: showing swelling of the feet, swelling of the face after waking up. Disturbance of breathing during sleep: is a complication from enlarged tonsils. There may be additional symptoms of snoring, lack of oxygen causing suffocation, and restless sleep.

Tonsillitis is usually treated medically to fight the infection with antibiotics. Tonsillitis will be indicated for surgical removal when:
The patient has more than 4 episodes of acute tonsillitis in a year. The size of the tonsils is too large to interfere with eating, breathing, swallowing, narrowing of the throat, causing snoring, sleep apnea or repeated infections. Tonsillitis has many complications such as abscess, otitis media, sinusitis or complications such as rheumatic heart disease, arthritis, glomerulonephritis. These cases, if not operated, can lead to dangerous complications such as inflammation, laryngitis, myocarditis, heart valve damage, autoimmune reactions.
Tonsillitis pus if not cut can cause bad breath, loss of confidence in communication. In children, recurrent tonsillitis is the cause of respiratory diseases or other disorders such as mental retardation, anorexia, bedwetting.

Tonsillectomy is a mid-surgery surgery, but it can also cause complications such as bleeding during or after surgery, infectious complications, anesthesia... even death for the patient.

Tonsillectomy, if performed with a Coblator or a plasma knife, takes only about 5-7 minutes, with less pain and less blood loss than with conventional cutting methods (about 30 minutes).
Most cases of tonsillectomy will be performed under anesthesia, the patient will recover after the surgery about 15-20 minutes. Because both anesthesia and anaesthesia can have complications due to local conditions, responsiveness, and technique... the doctor should consider carefully evaluating not to cut tonsils in any case.

The tonsils are the body that produces antibodies that play a role in fighting bacteria. If the indication for excision is not exactly indicated, it may not be necessary to weaken the immune system, causing harm to the body.
Even in the unfortunate case of tonsillectomy, it can cause fatal complications due to causes: anesthesia, improper cutting technique (touching blood vessels causing bleeding, not stopping bleeding). Therefore, before cutting the patient, it is necessary to do very careful tests on liver and kidney function and blood clotting to avoid unfortunate complications.
Contraindications for temporary tonsillectomy
Patients with unstable chronic diseases. Women who are pregnant and menstruating. Tonsillitis in the period of acute inflammation, with local complications (throat pain, congestive mucosa, high white blood cell > 10,000). The patient has a local or systemic infection such as a boil. Where outbreaks are occurring (influenza, measles, dengue fever) Patients younger than 5 years old and older than 55 years old. Absolute contraindications to tonsillectomy
Allergic diseases. Patients with blood diseases (prolonged bleeding, coagulation disorders, high blood pressure...) characteristics: tuberculosis, diabetes, chronic kidney failure. Should tonsils be removed for adults?
Adults can have their tonsils removed normally, but especially patients over 45 years old, if their tonsils are removed, they are prone to bleeding due to fibrous tonsils or other comorbidities such as hypertension, cardiovascular disease, diabetes...
Should tonsils be removed for young children?
Children under 5 years old, if their tonsils are removed, may affect their immunity and ability to recover for a long time.

To prevent tonsillitis, limit the risk of recurrence, it is necessary to keep the nasopharyngeal area warm, especially during the change of seasons and cold weather. At the same time, limit direct contact with polluted environments, avoid eating foods that are too hot or too cold, and maintain good oral hygiene. You should take the initiative to see an ENT specialist when you have abnormal symptoms such as fever 39-40 degrees, sore throat, difficulty swallowing, salivation, swollen, red, enlarged, painful tonsils, mucus and pus from tonsil cavity, swollen tongue...
Vinmec International General Hospital is a high-quality medical facility in Vietnam with a team of highly qualified, well-trained and specialized medical professionals. domestic and foreign, rich experience.
A system of modern medical equipment, especially the cutting-edge Coblator and Plasma knife cutting system, owns many of the best machines in the world to help detect many difficult and dangerous diseases in a short time, Support the most effective diagnosis and treatment of doctors. The hospital space is designed according to 5-star hotel standards, giving patients comfort, friendliness and peace of mind.