Tonsillar hypertrophy
tonsillitis acute, chronic and recurrent
tonsilar stones
peritonsillar abscess
by dissection and snare - extracapsular
electrocautery extracapsular
extracapsular tonsillectomy using ligasure/ harmonic scalpel
microdebrider assisted tonsil debulking- intracapsular
coblation assisted extracapsular
coblation assisted intrcapsular
coblation / microdebrider assisted tonsillotomy
depends on age of patient and the disease
for recurrent tonsillitis- extracapsular is better
As a part of Adenoidectomy tonsillotomy done to prevent size increase
as a part of procedures for snoring and sleep apnoea intracapsular prefered
in extracapsular tonsillectomy the remaining is raw muscles and exposed vessels
That area needs to heal, takes about 2 - 3 weeks
here bleeding can happen in 1st 24 hours when done with dissection and snare method
hence patient need to stay for 24hrs after surgery
Between day 7 and 10 there could be bleed secondary to infection of healing area
needs patient to get admitted injection to control bleeding
In intracapsular tonsillectomy the capsule is preserved and may retain minimal tonsil tissue
So the raw area is protected by tonsil capsule and tonsillar remanent
no significant risk of bleeding needing admission
Pain is least in this procedure
Tonsils can get infected any time in life
Extracapsular- around 2 weeks
Intrcapsular- normal ativities by 3-5 days