Tonsillectomy and(or) adenoidectomy are effective procedures for children with chronic tonsillitis, diseases associated with the tonsil and other adenotonsillar diseases, and obstructive sleep apnea-hypopnea syndrome. Since the tonsil and adenoid gland play a dual role in fluid and cell immunity, whether adenotonsillectomy results in the abnormal immune function in children after the surgery has always been the focus of attention. This review focuses on the alterations and impacts on immunity in children after tonsillectomy and/or adenoidectomy. Recent studies confirmed that in short term the immune index may be slightly reduced after the tonsil and adenoid resection in children, however, the decline has no clinical significance because the remaining mucosa-associated lymphoid tissue can compensate for removal of the tonsils and adenoids. Over time, the immune index tends to be normal. The children's postoperative short-term decline in the immune index will gradually recover to the preoperative level or there is no significant difference compared with that in normal children. Therefore, long-term immune function did not decline after tonsil and adenoid resection in children.
Adenoidectomy ; Adenoids ; surgery ; Child ; Humans ; Immunity, Cellular ; Palatine Tonsil ; surgery ; Postoperative Period ; Tonsillectomy ; Tonsillitis ; surgery

Objective:To investigate the changes of inflammation and immune function in children with chronic tonsillitis after tonsillotomy. Methods:Prospectively collected 60 children with obstructive sleep apnea （OSA） diagnosed as chronic tonsillitis with adenoids and tonsillar hypertrophy from January to June 2021. Two groups were divided, the experimental group （n=30） underwent bilateral partial tonsillectomy + adenoidectomy by hypothermia plasma ablation, and the control group （n=30） underwent adenoidectomy by using the same hypothermia plasma ablation method. The number of tonsillitis attacks before surgery and within one year after surgery was recorded, and the serum immunoglobulin IgM, IgG, IgA, complement C3 and complement C4 levels before operation, one month and three months after operation were measured. Results:The number of tonsillitis attacks in the experimental group and the control group at one year after surgery was lower than that before surgery（P<0.05）; The number of inflammatory attacks in the experimental group was （0.50±0.63） times/year, which was lower than that of （1.33±0.80） times/year in the control group. There was no significant difference in the five immunization results of the two groups at one month and three months after operation compared with before operation, and there was also no significant difference between the experimental and the control groups. Conclusion:Partial tonsillectomy can be applied to children with chronic tonsillitis, which can effectively reduce the number of tonsillitis attacks and has no effect on the immune function of children.
Child ; Humans ; Tonsillectomy/methods* ; Hypothermia ; Tonsillitis/surgery* ; Adenoidectomy ; Palatine Tonsil/surgery* ; Inflammation ; Chronic Disease ; Immunity

OBJECTIVETo investigate the advantages and disadvantages of ultracision-harmonic scalpel assisted tonsillectomy by compared with conventional tonsillectomy.

METHODSEighty-eight patients were randomly divided into ultrasonic scalpel group (group A, 42 cases) and control group (group B, 46 cases). The tonsillectomy in group A was performed with ultracision-harmonic scalpel, and in group B, the tonsillectomy was performed by routine method. The surgical time (complete removal of tonsils), blood loss, and postoperative sore throat situation were recorded.

RESULTSSurgical time in group A [(14.7 ± 4.0) min] was shorter than that in group B [(28.9 ± 7.6) min], t = -10.691, P < 0.05. Blood loss in group A [(3.1 ± 1.1) ml] was less than that in group B [(19.0 ± 5.2) ml], t = -19.544, P < 0.05. Postoperative sore throat was less painful in group A than that in group B in 10 hours after surgery, but much painful than group B 3 days after surgery and most patients lasted longer. There were statistical differences (P < 0.05). The average peel off time for the tunica albuginea was 8 days after the operation by using traditional method, by compared with the ultrasonic scalpel method, average time was 11 days, the difference showed statistical significance (t = 5.115, P < 0.05).

CONCLUSIONSCompared with traditional tonsillectomy, ultracision-harmonic scalpel tonsillectomy had shorter operative time, less blood loss and so on, but the sore throat symptoms persisted longer. In addition, the tunica albuginea peeled off later, so avoidance of secondary bleeding caused by improper diet was mandatory.

Adolescent ; Adult ; Female ; Humans ; Male ; Tonsillectomy ; methods ; Tonsillitis ; surgery ; Treatment Outcome ; Ultrasonic Therapy ; Young Adult

OBJECTIVETo investigate the feasibility of applying harmonic scalpel in tonsillectomy by comparing it with the conventional tonsillectomy.

METHODSThirty-five patients were treated by harmonic scalpel assisted tonsillectomy (harmonic scalpel group) and 35 patients were treated by conventional tonsillectomy (control group). The operating time and blood loss during operation and the degree of pain and post-tonsillectomy hemorrhage as well as the time of defining were observed.

RESULTSThe data of the operating time and blood loss during operation and the degree of pain in harmonic scalpel group were lower than that in the conventional group, the harmonic scalpel group had less perioperative bleeding (median 1 ml), short operation time (median 20 min), postoperative pain during 5 days with visual analogue scale was lighter (median from 5 scores down to 1 score), there was statistical difference (P < 0.01). Neither primary hemorrhage nor secondary hemorrhage occurred in harmonic scalpel group, while one primary hemorrhage and one secondary hemorrhage occurred in conventional group. No difference was found in the beginning time of defining (P > 0.05).

CONCLUSIONThe application of harmonic scalpel in tonsillectomy was safe, efficient and feasible, which had a nice application prospect in the field of otolaryngology.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Surgical Instruments ; Tonsillectomy ; instrumentation ; methods ; Tonsillitis ; surgery ; Treatment Outcome ; Ultrasonic Therapy ; instrumentation ; Young Adult

Gossypiboma is the term used to describe mass lesion caused by retained surgical sponges with reactive tissue after a surgical intervention. This condition has been mostly reported after abdominal or thoracic surgery. We recently experienced a case of gossypiboma of the peritonsillar space in a 31-year old male patient, who previously undergone incision and drainage for treatment of peritonsillar abscess but had persistent symptom of sore throat, myalgia and febrile sensation for 6 months. The gauze was accidently left in the peritonsillar space after a surgical intervention and resulted in mass like lesion in the ipsilateral peritonsillar space. To our knowledge, this is the first case of oropharyngeal gossypiboma in the literature. Although it is rare in adults, foreign body of peritonsillar space should be considered in the differential diagnosis of unilateral recurrent tonsillitis.
Adult ; Diagnosis, Differential ; Drainage ; Foreign Bodies ; Humans ; Male ; Palatine Tonsil ; Peritonsillar Abscess ; Pharyngitis ; Sensation ; Surgical Sponges ; Thoracic Surgery ; Tonsillectomy ; Tonsillitis

OBJECTIVE: To compare low temperature coblation assisted tonsillectomy with conventional dissection tonsillectomy intra-operation and after-operation. METHOD: Ninety-two pedia-patients were randomly divided into coblation-assisted tonsillectomy group and the control group. Arthrocine EVac 70 T&A Wand was used for coblation-assisted tonsillectomy, and the energy set was 7. Conventional dissection tonsillectomy was operated in control group. The operating time,bleeding,tonsillar fossae healing and return to normal diet and activities, intraoperative complications were recorded separately. Postoperative pain of the pedia-patients was recorded daily using Wong Baker FACES pain scale for 10 days of after-operation. RESULT: Coblation assisted group had a shorter operative time than the control group (10.2 min vs. 36.5 min, P<0.001). The average amount of intraoperative bleeding of Coblation assisted group was (6.83+/-3.36) ml, while the control group was (30.07+/-7.04) ml. Pedia-patients of Coblation group had a better pain score on 1, 2, 3 days after operation than in control group, and there was no statistically significant difference on 4 to 10 days between the two groups. Coblation group ones returned to normal diet earlier than the control group, but both group required similar time returned to normal activities. There was one patient in control group,who required suturing to stop bleeding for active oropharyngeal bleeding on the 6th day after operation. CONCLUSION Comparing with traditional dissection, Coblation assisted tonsillectomy is easy to perform with less intraoperative bleeding, shorter operation time, earlier return to normal diet, less pain on 1st to 3rd day postoperatively.
Adolescent ; Child ; Child, Preschool ; Cold Temperature ; Cryosurgery ; methods ; Dissection ; methods ; Female ; Humans ; Male ; Tonsillectomy ; methods ; Tonsillitis ; surgery ; Treatment Outcome

OBJECTIVE: To compare and analyse the efficiency of the low-temperature plasma radiofrequency and the traditional method in tonsillectomy. METHOD: Sixty-four patients with chronic tonsillitis were randomly divided into group A (39 cases) and group B (25 cases). Patients in the group A were treated with traditional method tonsillectomy while patients in the group B were treated with low-temperature plasma radio frequency tonsillectomy. Analysed differences in operation time, blood loss, and postoperative pain as well as the incidence of postoperative between two groups. RESULT: There were significant differences in operative time, blood loss, and postoperative pain (P < 0.05) between two groups, but there was no obvious difference in the incidence of postoperative bleeding (P > 0.05). CONCLUSION Low-temperature plasma radiofrequency tonsillectomy is a safer method and has many superiorities including shorter operative time, less blood loss, quicker recovery of postoperative pain compared with traditional tonsillectomy.
Adolescent ; Adult ; Cold Temperature ; Female ; Humans ; Hypothermia, Induced ; Male ; Middle Aged ; Tonsillectomy ; methods ; Tonsillitis ; surgery ; Young Adult

OBJECTIVE: To investigate the feasibility of applying ultracision-harmonic scalpel in tonsillectomy. METHOD: Thirty-one cases treated with tonsillectomy which applied with nasal endoscope and ultracision-harmonic scalpel (ultrasonic scalpel group) and 31 cases treated with routine operation (routine group) respectively. The operating time and blood loss during operation and the degree of pain and the region of inflammation humidity as well as hospitalization days were observed. RESULT: All indexes in ultrasonic scalpel group were lower than that in the routine group, including operating time and blood loss during operation, and they were obviously difference in statistics (P < 0.01). CONCLUSION The application of ultracision-harmonic scalpel in tonsillectomy was safe, efficient and feasible, and would have a nice application prospect during ear-nose-throat operation.
Adolescent ; Adult ; Chronic Disease ; Endoscopy ; Female ; Hemostasis, Surgical ; methods ; Humans ; Male ; Nasal Cavity ; surgery ; Tonsillectomy ; instrumentation ; methods ; Tonsillitis ; surgery ; Treatment Outcome ; Ultrasonic Therapy ; instrumentation ; Young Adult

OBJECTIVE: Tonsillectomy is one of the most frequently applied operations in the ENT practice. This prospective study compared intraoperative records and postoperative clinical outcomes between adults and children patients following monopolar electrocautery tonsillectomy. METHOD: Forty adult patients and Forty children patients with histories of recurrent tonsillitis or hypertrophic tonsillitis were enrolled. Intraoperative parameters and postoperative outcomes were compared. RESULT: Children tonsillectomy with monopolar electrocautery was significantly faster to perform (P < 0.05), and produced significantly less intraoperative blood loss (P < 0.05), and faster to return to commencement of a regular diet (P < 0.05) than adults. Children tonsillectomy endured less postopera- tive pain within a week (P > 0.05) than adults, but there was no significant difference in pain on the 14th postoperative day in two groups. There was no obvious postoperative hemorrhage in two groups. There was no significant difference in postoperative tonsillar fossa healing and postoperative temperature between the groups. CONCLUSION Children and adults tonsillectomy with monopolar electrocautery had clinical characteristics respectively. Monopolar electrocautery tonsillectomy was safe and operated easily in both two groups.
Adult ; Blood Loss, Surgical ; Child ; Electrocoagulation ; Humans ; Pain, Postoperative ; Postoperative Hemorrhage ; Postoperative Period ; Prospective Studies ; Tonsillectomy ; methods ; Tonsillitis ; surgery ; Wound Healing

Adult ; Aged ; Antigens, CD20 ; metabolism ; Diagnosis, Differential ; Female ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Humans ; Immunohistochemistry ; Leukocyte Common Antigens ; metabolism ; Lymphoma, B-Cell ; genetics ; metabolism ; pathology ; surgery ; Lymphoma, Extranodal NK-T-Cell ; pathology ; Lymphoma, Large B-Cell, Diffuse ; genetics ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Tonsillar Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Tonsillectomy ; Tonsillitis ; pathology ; Young Adult