Search
Weather in Bavaria
At night partly clear, partly cloudy, cooling down to 11 to 2 degrees Celsius
intercourse
BR Television – Health!
content
Tonsillitis Almonds: When should surgery be performed?
Every year 90,000 people are operated on the tonsils in Germany. The operation is one of the most frequent operations in the ENT area. For a long time it was controversial when and from which age surgery should be performed.
From: Tom Fleckenstein
In small children, the tonsils are still important for the development of the immune system. There have been many deaths after surgery. In Austria in 2006 even eight children died in one year due to heavy bleeding. A tonsillectomy is therefore not a trivial operation. According to the latest research, only part of the tonsils is increasingly removed. And there is a new guideline in Germany as to when surgery is recommended.
Mandeloplasty: yes or no?
The eight-year-old Diego from Traunreut simply had no appetite. In addition, the boys were constantly plagued by colds and bronchitis. He snored at night. Breathing even stopped. His mother was desperate.
“You just worry. He missed a lot. The kindergarten was not so bad. But school was hard. Since he is a good pupil, he made up for everything well. But he was often home sick.”
Tanja Hann, mother of Diego
Almonds: Are they important for the immune system?
Only a visit to the specialist doctor led to the diagnosis: Diego´s Almonds are too large, inflamed and have to be removed. But doesn’t he need them to defend his immune system?
“This is important and plays a role up to the age of six, but after that age the tonsils atrophy and no longer play a role in the immune system.”
Prof. Dr. med. Klaus Stelter, ENT Centre Mangfall-Inn
If the almonds are frequently inflamed, bacteria accumulate in the wrinkles and dimples, the so-called crypts of the almonds. This leads to infection and scarring of the tissue.
Tonsillitis: When and how is surgery performed today?
In the old days, the almonds would have been taken out completely. Today it’s different.
“For most children, partial removal is sufficient and the risk of secondary bleeding and pain is much lower and no comparison to complete removal is possible.
Prof. Dr. med. Klaus Stelter, ENT Centre Mangfall-Inn
Study from Denmark: Are children really healthier after surgery?
However, a new independent study from Denmark is currently under intense discussion. It deals with the long-term effects of tonsillectomy on children. The researchers examined data from almost 1.2 million patients who had their tonsils removed before the age of nine. The result: a significantly increased risk of later respiratory diseases such as asthma or pneumonia. But the study has weaknesses.
“The study comes up with a truly impressive case number of 1.2 million children. But only 40,000 of them had their tonsils removed. And that with the old method from the 1990s. The tonsils were removed completely. Nowadays we only partially remove the almonds. That cannot be compared with each other. Besides, the children may have been sicker because they came from smoking households. That has not been taken into account either.”
Prof. Dr. med. Klaus Stelter, ENT Centre Mangfall-Inn
Almonds: Outpost of the immune system
Bacteria and viruses can settle on the almonds and trigger infections.
Almonds are the outpost of our immune system and fight pathogens such as germs and viruses. But if they are constantly inflamed, they can lead to secondary diseases such as heart and kidney inflammation.
With Thomas Ertl, the problems always begin with scratches in the throat and extreme difficulty swallowing. In addition, there is a high fever.
“That’s real pain in the throat. You’ll be out of action for the next few days and weeks, there’s nothing left. The highlight was seven times a year tonsillitis.”
Thomas Ertl, patient
Tonsillitis: When household remedies no longer help
Tonsillitis can lead to high fever.
Salt water gargling, quark compresses or other household remedies don’t help much anymore. The 24-year-old must swallow antibiotics for every tonsillitis. They work on bacteria within 24 hours. But not with viruses. And they only fight the symptoms, not the cause. Here, too, the question arises: Do the tonsils have to come out? There is a new directive on this in Germany.
Mandrel Operation: New Guideline
“If you have over six tonsillitis cases a year that require antibiotics, you should operate. The patient will make a real profit.”
Privatdozent Dr. med. Klaus Stelter, ENT Centre Mangfall-Inn
Tonsillitis: When should surgery be performed?
With three to six inflammatory episodes per year, patients should be informed that the inflammations can also stop again with antibiotics or other means. Children are most often affected, but adults also suffer from tonsillitis. However, because the risk of postoperative bleeding is high and postoperative pain is severe, only part of the tonsils is increasingly removed.
Mandrel operation: lower risks through partial removal
“With the complete removal, you used to cut along the capsule so the muscle was free. Nowadays we leave a very thin rim of the almond tissue that protects the underlying muscle.”
Privatdozent Dr. med. Klaus Stelter, ENT Centre Mangfall-Inn
According to the current state of research, it is assumed that partial removal is just as effective as complete removal. The risk of dangerous secondary bleeding is ten times lower with partial removal than with complete removal. The patient does not have to stay in hospital for one week, but can go home after three days.
Almond surgery: Today, the tonsils are usually no longer removed completely.
Sometimes a too narrow nasal septum is also the cause of tonsillitis. Breathing through the mouth dries out the oral cavity and promotes infections. Diego had a successful operation. The tonsils were partially removed. He regains his appetite and sleeps through the night. Now he has more energy again. Even without tonsils his immune system will develop well.
Almond stones: unpleasant bad breath
Almonds can cause other problems: Almond stones. Actually everyone has them. But when they are no longer transported away, they lead to bad breath in combination with bacteria. This requires additional efforts in oral hygiene.
“Almond stones form in the almond from the dead cells and scales that are there in the deep grooves.”
Prof. Dr. med. Klaus Stelter, ENT Centre Mangfall-Inn
With a cupping glass one can have the almond stones sucked off according to the “Röder method” at the ENT doctor or alternative practitioner, which is however not exactly pleasant. But the almond stones come back. In the long run, an operation will also help here.