Advances in Tonsil Surgery
Tonsillectomy, the surgical removal of the tonsils, is a procedure that has been performed since before the Common Era and was documented by Hindu physicians. Modern medicine commonly performs tonsillectomy under general anesthesia, especially during the period from 1955 to 1970. Reports from America indicate millions of surgeries annually to treat children with chronic tonsillitis, significantly enlarged tonsils, and airway obstruction. However, these were still traditional tonsillectomies.
Currently, in America, approximately 400,000 tonsillectomies are performed annually. The indications remain the same: chronic tonsillitis, significantly enlarged tonsils causing airway obstruction, and tonsil stones (Tonsilloliths). Medical technology has since advanced, incorporating modern techniques such as Radio Frequency and CO2 Laser. With modern scientific knowledge, physicians can now treat tonsil diseases without completely removing the tonsils, allowing patients to retain their tonsillar tissue.
Modern medical science also recognizes that tonsils contain a large number of stem cells with higher potential than bone marrow stem cells and are easier to use. In the future, these stem cells could be used to treat various diseases such as cerebrovascular and heart artery blockages, lymphoma, and more. Furthermore, tonsil stem cells can repair tonsil tissue themselves.
Therefore, in countries with advanced medical development such as the United States, the United Kingdom, many European countries, as well as India and Bangladesh, modern tonsillectomy techniques have been developed. These use CO2 Laser to treat tonsil diseases without completely removing the tonsils, preserving quality tonsillar tissue. Tonsils serve as a frontline defense against respiratory infections, a function that continues throughout life, albeit reduced compared to childhood.
Tonsil Surgery with CO2 Laser
There are several methods depending on the cause of the tonsil disease. For example, if the patient has tonsil stones causing bad breath, treatment can be done by dissolving the deep crypts of the tonsils (CO2 Laser Cryptolysis). If the tonsils suffer from recurrent chronic inflammation (Recurrent Tonsillitis), treatment can be done by smoothing the outer surface of the tonsils (CO2 Laser Resurfacing). If the tonsillar tissue is more severely affected, surgery can remove almost all tonsillar tissue while leaving the outer capsule intact (CO2 Laser Tonsil Ablation).
Advantages of Using CO2 Laser in Tonsil Surgery
- Can be performed under topical and local anesthesia
- Minimal blood loss of 0-2 cc compared to traditional tonsillectomy which loses about 50-150 cc
- Postoperative bleeding occurs in 2-5% of cases, similar to traditional surgery
- Patients do not need to be hospitalized; the procedure can be safely done in an outpatient clinic with same-day discharge
- Postoperative pain is minimal, recovery is fast, and patients can return to work within 1-2 days, compared to traditional surgery requiring 2-3 days hospitalization, significant pain, and 1-2 weeks recovery
A Few Considerations
The tonsils are part of the body’s immune system. When treating tonsil diseases, it is preferable not to remove the tonsils entirely if possible. Modern surgical methods preserve healthy tonsillar tissue, allowing it to continue functioning without the patient losing the organ. Tonsillectomy should be reserved for life-threatening conditions such as cancer or cases where the tonsils are severely diseased and cannot be preserved, which accounts for no more than 1-2% of all tonsil diseases.
In America, CO2 Laser tonsil surgery is performed in every state. Due to the reasons and benefits mentioned above, most patients choose this method widely in both America and Europe. It can be said that in the future, Thailand will see an increase in tonsil surgeries. However, in America, only ENT surgeons with extensive experience in traditional tonsillectomy and proficiency in CO2 Laser surgery are authorized to perform this procedure.
